Provider Demographics
NPI:1598039877
Name:ELITE RX INC
Entity Type:Organization
Organization Name:ELITE RX INC
Other - Org Name:GODDARD DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:MUSLEH
Authorized Official - Last Name:MURSHED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-434-5137
Mailing Address - Street 1:25418 GODDARD RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-6200
Mailing Address - Country:US
Mailing Address - Phone:313-299-3300
Mailing Address - Fax:
Practice Address - Street 1:25418 GODDARD RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6200
Practice Address - Country:US
Practice Address - Phone:313-299-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-03
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy