Provider Demographics
NPI:1942937628
Name:ELITE MOBILE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ELITE MOBILE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ARMANTROUT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:760-777-5415
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:TOPOCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86436-0446
Mailing Address - Country:US
Mailing Address - Phone:760-777-5415
Mailing Address - Fax:
Practice Address - Street 1:4567 PARK DR
Practice Address - Street 2:
Practice Address - City:TOPOCK
Practice Address - State:AZ
Practice Address - Zip Code:86436
Practice Address - Country:US
Practice Address - Phone:760-777-5415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)