Organization
5 STAR ELITE MEDICAL TRANSPORTATION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP MARC- ANTHONY BLEVINS (OWNER)
(219) 577-2067
Entity
Organization
Contact information
Practice address
349 KING ST, GARY, IN 46406-1350
(219) 577-2067
Mailing address
349 KING ST, GARY, IN 46406-1350
(219) 577-2067
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0630-21-7075
IN
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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