Organization
ELIM PREFERRED SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M LETICH (CHIEF OPERATING OFFICER)
(763) 550-9486
Entity
Organization
Contact information
Practice address
2820 VICKSBURG LN N, PLYMOUTH, MN 55447-1878
(763) 550-9486
(763) 550-1458
Mailing address
2820 VICKSBURG LN N, PLYMOUTH, MN 55447-1878
(763) 550-9486
(763) 550-1458
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109527
UCARE
MN
01
—
75264EL
BCBS
MN
01
—
8200116
MEDICA PRIMARY
MN
01
—
8214411
MEDICA CHOICE
MN
Enumeration date
08/20/2006
Last updated
08/22/2020
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