Provider Demographics
NPI:1336214170
Name:ELITE DME, INC.
Entity Type:Organization
Organization Name:ELITE DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-240-7377
Mailing Address - Street 1:1212 N COUNTRY RD
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-1919
Mailing Address - Country:US
Mailing Address - Phone:631-240-7377
Mailing Address - Fax:631-326-6098
Practice Address - Street 1:1212 N COUNTRY RD
Practice Address - Street 2:SUITE 4B
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-1919
Practice Address - Country:US
Practice Address - Phone:631-240-7377
Practice Address - Fax:631-326-6098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies