Provider Demographics
NPI:1740845726
Name:ELITE CARE TRANSPORTATION, LLC
Entity type:Organization
Organization Name:ELITE CARE TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:614-260-3375
Mailing Address - Street 1:121 BRISTO ST
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1300
Mailing Address - Country:US
Mailing Address - Phone:614-843-4228
Mailing Address - Fax:
Practice Address - Street 1:121 BRISTO ST
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1300
Practice Address - Country:US
Practice Address - Phone:614-843-4228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)