Provider Demographics
NPI:1376352328
Name:ELITE MOBILITY LLC
Entity type:Organization
Organization Name:ELITE MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YARED
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-600-2445
Mailing Address - Street 1:3068 BLUFFHOLLOW GAP
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4295
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3068 BLUFFHOLLOW GAP
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4295
Practice Address - Country:US
Practice Address - Phone:615-600-2445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-04
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)