Organization · NPI-2

Elite Prime Life

Secured Medical Transport (VAN) · Plano, TX

NPI number1689254773
StatusActive
Last updated in NPPESApr 12, 2021

Details

NPI
1689254773
Entity type
Organization (NPI-2)
Legal business name
Elite Prime Life
Organization subpart
No
Enumeration date
Apr 12, 2021
Certification date
Apr 12, 2021
Last updated
Apr 12, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
343800000X Secured Medical Transport (VAN)––Yes

Practice location

5700 Tennyson Pkwy Ste 300
Plano, TX 75024-3595

Phone 424-346-2474

Mailing address

5700 Tennyson Pkwy Ste 300
Plano, TX 75024-3595

Phone 424-346-2474

Authorized official

Jarvitz Richmond
Coo
4243462474

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