Provider Demographics
NPI:1700986593
Name:ELITE MEDICAL SERVICES, L.L.C
Entity Type:Organization
Organization Name:ELITE MEDICAL SERVICES, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:TOMMY
Authorized Official - Last Name:ROBICHEAUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-856-1001
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-0031
Mailing Address - Country:US
Mailing Address - Phone:337-856-1001
Mailing Address - Fax:337-856-1002
Practice Address - Street 1:203 CHURCH ST
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592
Practice Address - Country:US
Practice Address - Phone:337-856-1001
Practice Address - Fax:337-856-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1409031Medicaid
LA1409031Medicaid
LA5800790001Medicare NSC