Provider Demographics
NPI:1144921107
Name:ELI PHARMACY CORPORATION
Entity type:Organization
Organization Name:ELI PHARMACY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:678-835-9997
Mailing Address - Street 1:1585 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2838
Mailing Address - Country:US
Mailing Address - Phone:224-234-4511
Mailing Address - Fax:
Practice Address - Street 1:11305 BELL RD
Practice Address - Street 2:STE 107
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-9503
Practice Address - Country:US
Practice Address - Phone:678-835-9997
Practice Address - Fax:678-835-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy