Provider Demographics
NPI:1871892349
Name:ELJ PHARMACY INC
Entity type:Organization
Organization Name:ELJ PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:ELYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-418-3100
Mailing Address - Street 1:2745 W HILLSBORO BLVD
Mailing Address - Street 2:STE 6
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8491
Mailing Address - Country:US
Mailing Address - Phone:954-418-3100
Mailing Address - Fax:954-418-6494
Practice Address - Street 1:2745 W HILLSBORO BLVD
Practice Address - Street 2:STE 6
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8491
Practice Address - Country:US
Practice Address - Phone:954-418-3100
Practice Address - Fax:954-418-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25346333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy