Provider Demographics
NPI:1215055082
Name:ELITE HEALTHCARE PLC
Entity type:Organization
Organization Name:ELITE HEALTHCARE PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHUKAIRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-232-0100
Mailing Address - Street 1:1501 S CENTER RD
Mailing Address - Street 2:STE # 3
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509
Mailing Address - Country:US
Mailing Address - Phone:810-780-4181
Mailing Address - Fax:810-519-4842
Practice Address - Street 1:1455 S LAPEER RD
Practice Address - Street 2:STE # 102
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360
Practice Address - Country:US
Practice Address - Phone:248-232-0100
Practice Address - Fax:248-232-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care