Provider Demographics
NPI:1538527130
Name:ELKABARY ENTERPRISES LLC, DBA VERACITY PHARMACY
Entity type:Organization
Organization Name:ELKABARY ENTERPRISES LLC, DBA VERACITY PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAN (AMY)
Authorized Official - Middle Name:
Authorized Official - Last Name:ALYELDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:813-677-8811
Mailing Address - Street 1:13135 KINGS LAKE DR
Mailing Address - Street 2:UNIT 102
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3960
Mailing Address - Country:US
Mailing Address - Phone:813-677-8811
Mailing Address - Fax:813-677-8812
Practice Address - Street 1:13135 KINGS LAKE DR
Practice Address - Street 2:UNIT 102
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-3960
Practice Address - Country:US
Practice Address - Phone:813-677-8811
Practice Address - Fax:813-677-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 299823336C0004X, 332B00000X, 333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy