NPIMap

Organization Active NPI

Elite Care Pharmacy Inc

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1386974376
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 54582 Issued in CA
Legal business name
ELITE CARE PHARMACY INC
Practice address
5101 Santa Monica Blvd
#6
Los Angeles, CA 90029-2478
Phone
(323) 426-9990
Fax
(323) 522-3611
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Mrs. Lusik L. Davtyan, PHARMACY TECH
Title
President / Owner
Phone
(323) 426-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY 54582 CA Primary

Addresses

Primary practice location

5101 Santa Monica Blvd
#6
Los Angeles, CA 90029-2478

Mailing address

5101 Santa Monica Blvd
#6
Los Angeles, CA 90029-2478
Phone (323) 426-9990

Other identifiers 2

IdentifierTypeStateIssuer
PHY 54582OtherCACALIFORNIA STATE BOARD OF PHARMACY PERMIT
PHY 54582OtherCANCPDP NUMBER

Other names 1

  • ELITE CARE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5101 Santa Monica Blvd
Ste 6
Los Angeles, CA 90029
Phone (323) 426-9990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1386974376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 SANTA MONICA BLVD",
            "address_2": "#6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292478",
            "telephone_number": "323-426-9990",
            "fax_number": "323-522-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 SANTA MONICA BLVD",
            "address_2": "#6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292478",
            "telephone_number": "323-426-9990",
            "fax_number": "323-522-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "DAVTYAN",
        "authorized_official_first_name": "LUSIK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "323-426-9990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMACY TECH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 54582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF PHARMACY PERMIT",
            "identifier": "PHY 54582",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "PHY 54582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELITE CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.