Provider Demographics
NPI:1003690835
Name:ELITE MEDICAL TRANSPORTATION SERVICES CO
Entity type:Organization
Organization Name:ELITE MEDICAL TRANSPORTATION SERVICES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EKATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-757-7600
Mailing Address - Street 1:875 LUMINARY CIR UNIT 106
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-6648
Mailing Address - Country:US
Mailing Address - Phone:321-757-7600
Mailing Address - Fax:321-757-2199
Practice Address - Street 1:875 LUMINARY CIR UNIT 106
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-6648
Practice Address - Country:US
Practice Address - Phone:321-757-7600
Practice Address - Fax:321-757-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)