MEDICARE: N-ELITE PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124649272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N-ELITE PHARMACY LLC

Provider Business Mailing Address
First Line	:	4806 RIVERSTONE BLVD STE A
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4092
Country	:	US
Telephone Number	:	281-778-4808
Fax Number	:	844-274-1672

Provider Business Practice Location Address
First Line	:	4806 RIVERSTONE BLVD STE A
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4092
Country	:	US
Telephone Number	:	281-778-4808
Fax Number	:	844-274-1672

Authorized Official
Title or Position	:	OWER/PIC
Name	:	MRS. SARIA T NELSON
Credential	:	PHARMD
Telephone Number	:	281-778-4808

Provider Enumeration Date	:	04/29/2020
Last Update Date	:	10/28/2021

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Directions to “N-ELITE PHARMACY LLC ” Practice Location

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