Organization
ELITE SUPPLY SERVICES, INC.
Active
Other names
Elite Group Warren
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY LAMONT SOUTHERLAND JD (PRESIDENT)
(910) 978-9118
Entity
Organization
Contact information
Practice address
2148 BUS-US 401, RAEFORD, NC 28376
(910) 565-2857
Mailing address
PO BOX 417, RAEFORD, NC 28376-0417
(910) 248-6258
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/18/2020
Last updated
03/04/2023
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