Organization
OMNI ELITE ENTERPRISES, LLC
Active
Parent organization
OMNI ELITE ENTERPRISES, LLC
Other names
Omni Elite Diagnostics
Organization subpart
Yes
Provider details
NPI number
Legal business name
OMNI ELITE ENTERPRISES, LLC
Authorized official
MR. KERWIN PITTTMAN (CHIEF EXECUTIVE OFFICER)
(919) 520-1194
Entity
Organization
Contact information
Practice address
4909 WATERS EDGE DR STE 218, RALEIGH, NC 27606-2462
(919) 520-1194
Mailing address
4909 WATERS EDGE DR STE 218, RALEIGH, NC 27606-2462
(919) 520-1194
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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