Provider Demographics
NPI:1144362138
Name:ELOMAR DRUGS CORPORATION
Entity type:Organization
Organization Name:ELOMAR DRUGS CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELOY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-529-0003
Mailing Address - Street 1:2741 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3201
Mailing Address - Country:US
Mailing Address - Phone:305-529-0003
Mailing Address - Fax:305-529-1022
Practice Address - Street 1:2741 CORAL WAY
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3201
Practice Address - Country:US
Practice Address - Phone:305-529-0003
Practice Address - Fax:305-529-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH0013600332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103341701Medicaid
FL1214710001Medicare NSC