Provider Demographics
NPI:1326880741
Name:ELITE CLINICAL CARE PHARMACY INC
Entity type:Organization
Organization Name:ELITE CLINICAL CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ARSHALUYS
Authorized Official - Last Name:GABRIELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-970-6804
Mailing Address - Street 1:9103 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3920
Mailing Address - Country:US
Mailing Address - Phone:818-724-8111
Mailing Address - Fax:818-875-2057
Practice Address - Street 1:9103 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3920
Practice Address - Country:US
Practice Address - Phone:818-724-8111
Practice Address - Fax:818-875-2057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELITE CLINICAL CARE PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy