Provider Demographics
NPI:1750846226
Name:ELEMENTS PHARMACY INC.
Entity Type:Organization
Organization Name:ELEMENTS PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:IEONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-888-3366
Mailing Address - Street 1:3808 UNION ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5544
Mailing Address - Country:US
Mailing Address - Phone:718-888-3366
Mailing Address - Fax:718-888-2288
Practice Address - Street 1:3808 UNION ST STE D2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5544
Practice Address - Country:US
Practice Address - Phone:718-888-3366
Practice Address - Fax:718-888-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy