Provider Demographics
NPI:1265277172
Name:ELITE COMPREHENSIVE CARE, PLLC
Entity type:Organization
Organization Name:ELITE COMPREHENSIVE CARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:TEGAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-222-7555
Mailing Address - Street 1:13094 NC HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:SURF CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28445-6588
Mailing Address - Country:US
Mailing Address - Phone:910-222-7555
Mailing Address - Fax:
Practice Address - Street 1:13094 NC HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445
Practice Address - Country:US
Practice Address - Phone:910-222-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty