Organization
ELITE MEDICAL PRODUCTS, INC.
Active
Organization
ELITE MEDICAL PRODUCTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON TRAVIS WALTERS (PRESIDENT / CEO)
(517) 398-0425
Entity
Organization
Contact information
Practice address
588 OLDS ST., JONESVILLE, MI 49250-9975
(517) 849-7259
(866) 929-8390
Mailing address
588 OLDS ST., JONESVILLE, MI 49250-9975
(517) 849-7259
(866) 929-8390
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6208460001
MI
332BC3200X
Customized Equipment (DME)
6208460001
MI
335E00000X
Prosthetic/Orthotic Supplier
6208460001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C000090
BCBS MI
MI
Enumeration date
08/12/2008
Last updated
08/30/2012
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