Provider Demographics
NPI:1982219234
Name:ELITE JFM INC
Entity Type:Organization
Organization Name:ELITE JFM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MCGOVERN
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-824-3120
Mailing Address - Street 1:1200 ROUTE 22 STE 200
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2943
Mailing Address - Country:US
Mailing Address - Phone:732-824-3120
Mailing Address - Fax:
Practice Address - Street 1:1200 ROUTE 22 STE 200
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2943
Practice Address - Country:US
Practice Address - Phone:732-824-3120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care