Provider Demographics
NPI:1376306266
Name:ELMORA RX PHARMACY LLC
Entity Type:Organization
Organization Name:ELMORA RX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSEHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-342-9324
Mailing Address - Street 1:9 HORSESHOE CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1921
Mailing Address - Country:US
Mailing Address - Phone:908-342-9324
Mailing Address - Fax:
Practice Address - Street 1:136 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1148
Practice Address - Country:US
Practice Address - Phone:908-342-9324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy