Healthcare Provider Details

I. General information

NPI: 1992379960
Provider Name (Legal Business Name): ELITE PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N WOOD AVE
LINDEN NJ
07036-4220
US

IV. Provider business mailing address

222 N WOOD AVE
LINDEN NJ
07036-4220
US

V. Phone/Fax

Practice location:
  • Phone: 908-587-2000
  • Fax: 908-357-2960
Mailing address:
  • Phone: 908-587-2000
  • Fax: 908-357-2960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS CONZO
Title or Position: PRESIDENT
Credential:
Phone: 973-337-0770