Elite Medical Products, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6208460001 Issued in MI

Legal business name

ELITE MEDICAL PRODUCTS, INC.

Practice address

588 Olds St.
Jonesville, MI 49250-9975

Phone

(517) 849-7259

Fax

(866) 929-8390

NPI assigned

Aug 12, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jason Travis Walters

Title

President / Ceo

Phone

(517) 398-0425

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1972759801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 OLDS ST.",
            "city": "JONESVILLE",
            "state": "MI",
            "postal_code": "492509975",
            "telephone_number": "517-849-7259",
            "fax_number": "866-929-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 OLDS ST.",
            "city": "JONESVILLE",
            "state": "MI",
            "postal_code": "492509975",
            "telephone_number": "517-849-7259",
            "fax_number": "866-929-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL PRODUCTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "517-398-0425",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "6208460001",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MI",
            "license": "6208460001",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "6208460001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "540C000090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jihad Davis, MA, DP-C
• Matthew P Dillon, PA-C
• Wesley Andrew Dove
• Sharon L Dow, DDS
• Veronica Edgar
• Maria Ethridge
• Randy Lee Evans, MA
• Stephanie Evans
• Extrodinary Solutions L.L.C.
• Melissa Louise Finney

• Durable Medical Equipment & Medical Supplies in Jonesville, MI
• Providers in Jonesville, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.