Provider Demographics
NPI:1326388836
Name:ELU INC
Entity Type:Organization
Organization Name:ELU INC
Other - Org Name:POINT BREEZE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYENE
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:267-939-8449
Mailing Address - Street 1:3900 FORD RD APT 19L
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2042
Mailing Address - Country:US
Mailing Address - Phone:267-939-8449
Mailing Address - Fax:267-886-9157
Practice Address - Street 1:2101 S 19TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-3709
Practice Address - Country:US
Practice Address - Phone:267-886-9150
Practice Address - Fax:267-886-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4823583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102797260Medicaid