Provider Demographics
NPI:1154332823
Name:ELITE MEDCO, LLC
Entity Type:Organization
Organization Name:ELITE MEDCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TIJMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-2032
Mailing Address - Street 1:320 N MCCOLL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-9348
Mailing Address - Country:US
Mailing Address - Phone:956-687-2032
Mailing Address - Fax:956-971-9306
Practice Address - Street 1:320 N MCCOLL RD
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-9348
Practice Address - Country:US
Practice Address - Phone:956-687-2032
Practice Address - Fax:956-971-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies