Provider Demographics
NPI:1093228249
Name:ELIZUR CORPORATION
Entity Type:Organization
Organization Name:ELIZUR CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SUPPORT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-358-4523
Mailing Address - Street 1:9800A MCKNIGHT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6032
Mailing Address - Country:US
Mailing Address - Phone:412-358-4523
Mailing Address - Fax:412-358-4518
Practice Address - Street 1:3524 BOULEVARD OF THE ALLIES
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-4312
Practice Address - Country:US
Practice Address - Phone:844-628-8813
Practice Address - Fax:800-933-1356
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELIZUR CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000008918332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier