Provider Demographics
NPI:1851932537
Name:ELITEPHARMA-RX
Entity Type:Organization
Organization Name:ELITEPHARMA-RX
Other - Org Name:KEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-300-5225
Mailing Address - Street 1:613 UPTOWN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3512
Mailing Address - Country:US
Mailing Address - Phone:469-575-0034
Mailing Address - Fax:469-214-4911
Practice Address - Street 1:613 UPTOWN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3512
Practice Address - Country:US
Practice Address - Phone:469-575-0034
Practice Address - Fax:682-888-1593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy