Provider Demographics
NPI:1720555808
Name:ELITE MEDICAL INC
Entity Type:Organization
Organization Name:ELITE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANI
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:ENGLEHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-325-1977
Mailing Address - Street 1:6002 WESTGATE BLVD STE 272
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2571
Mailing Address - Country:US
Mailing Address - Phone:206-234-6182
Mailing Address - Fax:253-383-8386
Practice Address - Street 1:6002 WESTGATE BLVD STE 272
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2571
Practice Address - Country:US
Practice Address - Phone:206-234-6182
Practice Address - Fax:253-383-8386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies