Provider Demographics
NPI:1851406151
Name:ELIM PREFERRED SERVICES INC.
Entity Type:Organization
Organization Name:ELIM PREFERRED SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:LETICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-550-9486
Mailing Address - Street 1:2820 VICKSBURG LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1878
Mailing Address - Country:US
Mailing Address - Phone:763-550-9486
Mailing Address - Fax:763-550-1458
Practice Address - Street 1:2820 VICKSBURG LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1878
Practice Address - Country:US
Practice Address - Phone:763-550-9486
Practice Address - Fax:763-550-1458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN75264ELOtherBCBS
MN109527OtherUCARE
MN8200116OtherMEDICA PRIMARY
MN8214411OtherMEDICA CHOICE
=========OtherNALC
MN109527OtherUCARE
=========OtherHUMANA
=========OtherMEDI-BILL
=========OtherWEA
=========OtherPHELPS DODGE CORP.
MN=========OtherBANKERS LIFE & CASUALTY
=========OtherGEHA
MN=========OtherCOMBINED INSURANCE
=========OtherHUMANA GOLD CHOICE
MN75264ELOtherBCBS
MN8200116OtherMEDICA PRIMARY
MN=========OtherAARP
=========OtherNALC