Provider Demographics
NPI:1588009336
Name:ELITE CARE OF NC, LLC
Entity Type:Organization
Organization Name:ELITE CARE OF NC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-655-8313
Mailing Address - Street 1:740 JACOBS RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:NC
Mailing Address - Zip Code:28423-8924
Mailing Address - Country:US
Mailing Address - Phone:910-655-8313
Mailing Address - Fax:
Practice Address - Street 1:740 JACOBS RD
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:NC
Practice Address - Zip Code:28423-8924
Practice Address - Country:US
Practice Address - Phone:910-655-8313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1815341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance