Provider Demographics
NPI:1508648841
Name:EL PASO SPECIALTY INVESTMENT LLC
Entity Type:Organization
Organization Name:EL PASO SPECIALTY INVESTMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-591-3099
Mailing Address - Street 1:1400 GEORGE DIETER DR STE 180
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7656
Mailing Address - Country:US
Mailing Address - Phone:915-302-6555
Mailing Address - Fax:905-302-6555
Practice Address - Street 1:1400 GEORGE DIETER DR STE 180
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7656
Practice Address - Country:US
Practice Address - Phone:915-302-6555
Practice Address - Fax:905-302-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy