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General NPI Number Information
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NPI Number | 1609043546
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Entity Type | Organization
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Legal Business Name | ELIKE INC
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 701 N TEXAS BLVD
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City | ALICE
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State | TX
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Zip | 78332-3883
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Country | US
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Telephone | 361-664-7455
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Fax | 361-664-7461
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Provider Business Mailing Address
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Address Line | 701 N TEXAS BLVD
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City | ALICE
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State | TX
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Zip | 78332-3883
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Country | US
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Telephone | 361-664-7455
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Fax | 361-664-7461
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Authorized Official
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Title or Position | RPH/PIC/PRESIDENT
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Name | ELSA ORNELAS
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Credential | RPH
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Telephone | 361-664-7455
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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 | 26017
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License Number State | TX
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