Provider Demographics
NPI:1609635622
Name:ELI MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ELI MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTERROSAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-863-1929
Mailing Address - Street 1:28610 HIGHWAY 290 STE F09
Mailing Address - Street 2:#252
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5463
Mailing Address - Country:US
Mailing Address - Phone:832-684-1951
Mailing Address - Fax:
Practice Address - Street 1:23819 WIMBLE DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-2065
Practice Address - Country:US
Practice Address - Phone:832-684-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies