Provider Demographics
NPI:1962280693
Name:ELLETTE MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:ELLETTE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASTGHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PILOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:818-433-8817
Mailing Address - Street 1:231 W TUJUNGA AVE APT D
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-3116
Mailing Address - Country:US
Mailing Address - Phone:818-433-8817
Mailing Address - Fax:
Practice Address - Street 1:325 N FIRST ST APT 315
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1888
Practice Address - Country:US
Practice Address - Phone:818-433-8817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)