Provider Demographics
NPI:1720804693
Name:ELIXIR RX INC
Entity type:Organization
Organization Name:ELIXIR RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:818-474-5750
Mailing Address - Street 1:PO BOX 920070
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91392-0070
Mailing Address - Country:US
Mailing Address - Phone:818-474-5750
Mailing Address - Fax:818-474-5740
Practice Address - Street 1:13752 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3193
Practice Address - Country:US
Practice Address - Phone:818-474-5750
Practice Address - Fax:818-474-5740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy