Provider Demographics
NPI:1275167827
Name:ELEVATION RX LLC
Entity Type:Organization
Organization Name:ELEVATION RX LLC
Other - Org Name:ELEVATION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZAGDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-472-9565
Mailing Address - Street 1:7651 MATAPEAKE BUSINESS DR STE 114
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3038
Mailing Address - Country:US
Mailing Address - Phone:240-685-2830
Mailing Address - Fax:240-685-2830
Practice Address - Street 1:7651 MATAPEAKE BUSINESS DR STE 114
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-3038
Practice Address - Country:US
Practice Address - Phone:240-685-2830
Practice Address - Fax:240-685-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-22
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy