Provider Demographics
NPI:1013914217
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:MR
Authorized Official - First Name:AMAURY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-737-2212
Mailing Address - Street 1:10017 JEFFERSON HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2471
Mailing Address - Country:US
Mailing Address - Phone:504-737-2212
Mailing Address - Fax:504-737-2272
Practice Address - Street 1:10017 JEFFERSON HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-2471
Practice Address - Country:US
Practice Address - Phone:504-737-2212
Practice Address - Fax:504-737-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5472-IR332B00000X, 332BN1400X, 332BP3500X, 332BX2000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA14-156223OtherJEFF PARISH OCCUP. LICENS
LAC005472-IROtherLABP CDS PERMIT NO.
1932107OtherNCPDP NUMBER
LA5472-IROtherLABP PERMIT NO.
LA1274771Medicaid
LA545055-2OtherDEPT OF LABOR NUMBER
LA545055-2OtherDEPT OF LABOR NUMBER
=========OtherFEDERAL ID NUMBER
5425350001Medicare ID - Type UnspecifiedDME/POS PROVIDER NO.