Provider Demographics
NPI:1174105902
Name:ELITE XPRESS TRANSPORTATION LLC
Entity type:Organization
Organization Name:ELITE XPRESS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:LA VON
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-805-1696
Mailing Address - Street 1:PO BOX 531309
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45253-1309
Mailing Address - Country:US
Mailing Address - Phone:513-429-2861
Mailing Address - Fax:513-521-3793
Practice Address - Street 1:2418 COMPTON RD STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2928
Practice Address - Country:US
Practice Address - Phone:513-429-2861
Practice Address - Fax:513-521-3793
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELITE XPRESS TRANSPORTATION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)