Provider Demographics
NPI:1942653373
Name:ELITE INC
Entity Type:Organization
Organization Name:ELITE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONIYOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMILOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-207-8137
Mailing Address - Street 1:17989 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-5909
Mailing Address - Country:US
Mailing Address - Phone:720-207-8137
Mailing Address - Fax:
Practice Address - Street 1:17989 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-5909
Practice Address - Country:US
Practice Address - Phone:720-207-8137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB-10047343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB-10047OtherPUBLIC UTILITY COMMISSION