Provider Demographics
NPI:1568134385
Name:ELITE INFUSION
Entity Type:Organization
Organization Name:ELITE INFUSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-473-3371
Mailing Address - Street 1:16575 SEMINOLE RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6947
Mailing Address - Country:US
Mailing Address - Phone:317-473-3371
Mailing Address - Fax:
Practice Address - Street 1:16575 SEMINOLE RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-6947
Practice Address - Country:US
Practice Address - Phone:317-473-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty