Organization
ELITE EMERGENCY PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN RHODES (BILLING ADMINISTRATOR)
(574) 271-2558
Entity
Organization
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 271-2558
Mailing address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 271-2558
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100112790B
—
IN
Enumeration date
08/16/2006
Last updated
09/03/2019
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