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General NPI Number Information
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NPI Number | 1346253515
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Entity Type | Organization
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Legal Business Name | ELITE MUS HOLDINGS LLC
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 2555 NORTH WOLF CREEK DRIVE
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City | EDEN
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State | UT
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Zip | 84310
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Country | US
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Telephone | 801-745-1800
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Fax | 801-745-0600
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Provider Business Mailing Address
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Address Line | 2555 N WOLF CREEK DR
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City | EDEN
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State | UT
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Zip | 84310
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Country | US
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Telephone | 801-745-1800
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Fax | 801-745-0600
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Authorized Official
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Title or Position | OWNER/PIC
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Name | THOMAS CARTER MUSGRAVE
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Credential |
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Telephone | 801-745-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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