Provider Demographics
NPI:1437585239
Name:ELITE CARE INC
Entity Type:Organization
Organization Name:ELITE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRICE
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-792-7812
Mailing Address - Street 1:3836 ABBY LYNN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-7315
Mailing Address - Country:US
Mailing Address - Phone:252-814-6957
Mailing Address - Fax:
Practice Address - Street 1:715 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3842
Practice Address - Country:US
Practice Address - Phone:919-734-0483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care