Provider Demographics
NPI:1295939684
Name:ELITE NURSING STAFF
Entity type:Organization
Organization Name:ELITE NURSING STAFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-693-6400
Mailing Address - Street 1:125 OLD WAREHOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-2953
Mailing Address - Country:US
Mailing Address - Phone:919-693-6400
Mailing Address - Fax:919-692-1011
Practice Address - Street 1:125 OLD WAREHOUSE SQ
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2953
Practice Address - Country:US
Practice Address - Phone:919-693-6400
Practice Address - Fax:919-692-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3217251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418040Medicaid
NC6601401Medicaid