NPIMap

Organization Active NPI

Elitemed, Inc.

Doing business as MedBridge Pharmacy

  • Community/Retail Pharmacy
  • Granada Hills, CA
National Provider Identifier
1083490361
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ELITEMED, INC.
Doing business as
MedBridge Pharmacy
Practice address
10515 Balboa Blvd Ste 125
Granada Hills, CA 91344-6354
Phone
(747) 600-9555
Fax
(747) 600-9555
NPI assigned
Sep 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adrineh Keshish
Title
Owner
Phone
(747) 600-9555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

10515 Balboa Blvd Ste 125
Granada Hills, CA 91344-6354

Mailing address

10515 Balboa Blvd Ste 125
Granada Hills, CA 91344-6354
Phone (747) 600-9555

Other names 1

  • MedBridge Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elitemed Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10515 Balboa Blvd
Ste 125
Granada Hills, CA 91344
Phone (747) 600-9555

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1083490361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 125",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446354",
            "telephone_number": "747-600-9555",
            "fax_number": "747-600-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 125",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446354",
            "telephone_number": "747-600-9555",
            "fax_number": "747-600-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITEMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "KESHISH",
        "authorized_official_first_name": "ADRINEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "747-600-9555"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedBridge Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.