Provider Information for 1710743471
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ELITE RX
Other Names:Doing Business As:ELITE RXOrganization Subpart: NO
NPI: 1710743471
Last Updated: 2024-11-16
Certification Date: 2024-11-16
Certification Date: 2024-11-16
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1710743471 | ||||||||||||||||||||
| Enumeration Date | 2024-02-21 | ||||||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Authorized Official Information | Name: JEFFREY S LANG PharmD Title: Pharmacist Phone: 7025389388 | ||||||||||||||||||||
| Mailing Address | 5960 THIROS CIRCLE LAS VEGAS, NV 89146 United States Phone: 702-673-2216 | Fax:702-768-8982 | ||||||||||||||||||||
| Primary Practice Address | 4845 S RAINBOW BLVD STE 403 LAS VEGAS, NV 89103-4750 United States Phone: 702-538-9388 | Fax:702-776-8982 | ||||||||||||||||||||
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