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General NPI Number Information
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NPI Number | 1871892349
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Entity Type | Organization
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Legal Business Name | ELJ PHARMACY INC
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 2745 W HILLSBORO BLVD STE 6
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8491
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Country | US
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Telephone | 954-418-3100
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Fax | 954-418-6494
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Provider Business Mailing Address
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Address Line | 2745 W HILLSBORO BLVD STE 6
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8491
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Country | US
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Telephone | 954-418-3100
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Fax | 954-418-6494
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Authorized Official
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Title or Position | PD
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Name | ELYSE STERN
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Credential |
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Telephone | 954-418-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PS25346
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License Number State | FL
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