Healthcare Provider Details

I. General information

NPI: 1316405640
Provider Name (Legal Business Name): ELIZUR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W BALTIMORE ST STE 3
MCMECHEN WV
26040-1503
US

IV. Provider business mailing address

9800A MCKNIGHT RD STE 200
PITTSBURGH PA
15237-6032
US

V. Phone/Fax

Practice location:
  • Phone: 844-628-8813
  • Fax:
Mailing address:
  • Phone: 412-358-4523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BRENDA ROBERTS
Title or Position: BUSINESS SUPPORT
Credential:
Phone: 412-358-4523