Provider Demographics
NPI:1124649272
Name:N-ELITE PHARMACY LLC
Entity type:Organization
Organization Name:N-ELITE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWER/PIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-778-4808
Mailing Address - Street 1:4806 RIVERSTONE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4092
Mailing Address - Country:US
Mailing Address - Phone:281-778-4808
Mailing Address - Fax:844-274-1672
Practice Address - Street 1:4806 RIVERSTONE BLVD STE A
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4092
Practice Address - Country:US
Practice Address - Phone:281-778-4808
Practice Address - Fax:844-274-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150382Medicaid