Provider Demographics
NPI:1376243584
Name:ELITE HEALTH RX PHARMACY LLC
Entity Type:Organization
Organization Name:ELITE HEALTH RX PHARMACY LLC
Other - Org Name:ELITE HEALTH RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RASH-DAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DANMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:832-287-8776
Mailing Address - Street 1:PO BOX 1576
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-1576
Mailing Address - Country:US
Mailing Address - Phone:346-818-2658
Mailing Address - Fax:
Practice Address - Street 1:18700 BECKER RD STE A101
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-6946
Practice Address - Country:US
Practice Address - Phone:346-818-2658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy