# ELITE SENIOR SUPPLIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063198166
- **Authorized official:** OVAIS ILYAS MIANNOOR (MANAGER)
- **Authorized official phone:** (786) 647-0118

## Contact information

- **Practice address:** 1320 SE FEDERAL HWY STE 206, STUART, FL 34994-3410
- **Practice address phone:** (877) 381-9343
- **Mailing address:** 1320 SE FEDERAL HWY STE 206, STUART, FL 34994-3410
- **Mailing address phone:** (877) 381-9343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 06/23/2023
- **Last updated:** 07/27/2023