Provider Demographics
NPI:1295095206
Name:ELITE MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:ELITE MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-200-3912
Mailing Address - Street 1:PO BOX 3303
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95611-3303
Mailing Address - Country:US
Mailing Address - Phone:916-200-3912
Mailing Address - Fax:916-880-5479
Practice Address - Street 1:7425 THALIA CT
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-5589
Practice Address - Country:US
Practice Address - Phone:916-266-3085
Practice Address - Fax:916-880-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)