Provider Demographics
NPI:1780449355
Name:ELITE CARE TRANSPORTATION CO
Entity type:Organization
Organization Name:ELITE CARE TRANSPORTATION CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-735-5326
Mailing Address - Street 1:317 CENTRAL AVE N STE B
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5214
Mailing Address - Country:US
Mailing Address - Phone:612-261-8975
Mailing Address - Fax:
Practice Address - Street 1:317 CENTRAL AVE N STE B
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5214
Practice Address - Country:US
Practice Address - Phone:612-735-5326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)