Provider Demographics
NPI:1679217822
Name:ELITE PHARMACY INC
Entity Type:Organization
Organization Name:ELITE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-464-1788
Mailing Address - Street 1:7011 N MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3714
Mailing Address - Country:US
Mailing Address - Phone:813-373-5709
Mailing Address - Fax:813-373-5483
Practice Address - Street 1:7011 N MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3714
Practice Address - Country:US
Practice Address - Phone:813-373-5709
Practice Address - Fax:813-373-5483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH33791OtherCOMMUNITY / RETAIL PHARMACY