Provider Demographics
NPI:1447766084
Name:ELEAMS MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ELEAMS MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ELEAM
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:318-280-2279
Mailing Address - Street 1:301 TEXAS AVENUE
Mailing Address - Street 2:SAME
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-410-8900
Mailing Address - Fax:318-410-8900
Practice Address - Street 1:301 TEXAS AVENUE
Practice Address - Street 2:SAME
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-410-8900
Practice Address - Fax:318-410-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)