Provider Demographics
NPI:1992585616
Name:ELITE ULTRASOUND IMAGING I LLC
Entity type:Organization
Organization Name:ELITE ULTRASOUND IMAGING I LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SONOGRAPHER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:678-833-2433
Mailing Address - Street 1:6035 PEACHTREE RD STE C218
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30360-3240
Mailing Address - Country:US
Mailing Address - Phone:678-833-2433
Mailing Address - Fax:
Practice Address - Street 1:6035 PEACHTREE RD STE C218
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30360-3240
Practice Address - Country:US
Practice Address - Phone:678-833-2433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No293D00000XLaboratoriesPhysiological Laboratory