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General NPI Number Information
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NPI Number | 1851932537
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Entity Type | Organization
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Legal Business Name | ELITEPHARMA-RX
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 613 UPTOWN BLVD STE 105
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City | CEDAR HILL
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State | TX
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Zip | 75104-3512
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Country | US
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Telephone | 469-575-0034
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Fax | 682-888-1593
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Provider Business Mailing Address
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Address Line | 613 UPTOWN BLVD STE 105
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City | CEDAR HILL
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State | TX
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Zip | 75104-3512
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Country | US
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Telephone | 469-575-0034
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Fax | 469-214-4911
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER LLOYD
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Credential |
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Telephone | 817-300-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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