Provider Demographics
NPI:1528365509
Name:ELITE TRANSPORTATION
Entity Type:Organization
Organization Name:ELITE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-828-2670
Mailing Address - Street 1:4745 POPLAR AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4430
Mailing Address - Country:US
Mailing Address - Phone:901-828-2670
Mailing Address - Fax:
Practice Address - Street 1:9330 JAYNE LEWIS CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-0962
Practice Address - Country:US
Practice Address - Phone:901-828-2670
Practice Address - Fax:901-379-3530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55698333347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle