Provider Demographics
NPI:1124449327
Name:ELITE TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:ELITE TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MONA
Authorized Official - Last Name:TAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-300-6565
Mailing Address - Street 1:513 BOLIN TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8868
Mailing Address - Country:US
Mailing Address - Phone:180-069-8066
Mailing Address - Fax:180-069-8066
Practice Address - Street 1:513 BOLIN TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8868
Practice Address - Country:US
Practice Address - Phone:180-069-8066
Practice Address - Fax:180-069-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)