Provider Demographics
| NPI: | 1154170959 |
|---|---|
| Name: | ELITE REGIONS NEMT LLC |
| Entity type: | Organization |
| Organization Name: | ELITE REGIONS NEMT LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | EDDIE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WELLS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 678-907-1290 |
| Mailing Address - Street 1: | 7514 HOGAN RD APT 201 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | JACKSONVILLE |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 32216-4543 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 678-907-1290 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 7514 HOGAN RD APT 201 |
| Practice Address - Street 2: | |
| Practice Address - City: | JACKSONVILLE |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 32216-4543 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 678-907-1290 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-05-14 |
| Last Update Date: | 2024-05-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 261QM1102X | Ambulatory Health Care Facilities | Clinic/Center | Military Outpatient Operational (Transportable) Component |
| No | 261QM1103X | Ambulatory Health Care Facilities | Clinic/Center | Military Ambulatory Procedure Visits Operational (Transportable) |
| No | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| No | 332BD1200X | Suppliers | Durable Medical Equipment & Medical Supplies | Dialysis Equipment & Supplies |
| No | 332BN1400X | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies |
| No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition |
| No | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
