Organization
ELITE MEDICAL EQUIPMENT AND SUPPLIES, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD JAMES REMALY (OWNER)
(816) 468-1041
Entity
Organization
Contact information
Practice address
407 NE 76TH TER, GLADSTONE, MO 64118-1708
(816) 468-1041
(816) 468-1583
Mailing address
407 NE 76TH TER, GLADSTONE, MO 64118-1708
(816) 468-1041
(816) 468-1583
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1175709
USA MANAGED CARE ORGANIZATION
MO
01
—
47725017
BLUE CROSS BLUE SHIELD KC
MO
05
—
620001331
—
MO
Enumeration date
12/05/2011
Last updated
02/07/2013
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