Organization Active NPI

Elite Infusion Care LLC

Doing business as Elite Infusion Care

  • Home Infusion Agency
  • Fullerton, CA
National Provider Identifier
1760148456
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
ELITE INFUSION CARE LLC
Doing business as
Elite Infusion Care
Practice address
1440 N Harbor Blvd Ste 916
Fullerton, CA 92835-4127
Phone
(424) 324-9322
Fax
(424) 349-0011
NPI assigned
Nov 17, 2021
Last updated
Jun 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Dasheavia Q Jolly, RNNPI 1811335326
Title
Owner
Phone
(478) 978-3347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X Primary
Nursing Care Agency 251J00000X

Addresses

Primary practice location

1440 N Harbor Blvd Ste 916
Fullerton, CA 92835-4127

Mailing address

13607 Cordary Ave Apt 122
Hawthorne, CA 90250-7437
Phone (478) 978-3347

Other names 1

  • Elite Infusion Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Home infusion therapy
Medicare-enrolled home infusion therapy supplier

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230714001741 CA Part B Supplier - Home Infusion Therapy Supplier 4486014032 Practice locations: Fullerton, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2279018Elite Infusion Care, LLC1440 N. Harbor Blvd Suite 916, Fullerton, CA 92835Certificate of waiverMar 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1760148456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13607 CORDARY AVE APT 122",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507437",
            "telephone_number": "478-978-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 916",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354127",
            "telephone_number": "424-324-9322",
            "fax_number": "424-349-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE INFUSION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "JOLLY",
        "authorized_official_first_name": "DASHEAVIA",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-978-3347",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Infusion Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Infusion Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.