Organization Active NPI

Elite Clinical Care Pharmacy Inc

Doing business as Elite Clinical Care Pharmacy

  • Community/Retail Pharmacy
  • North Hills, CA
National Provider Identifier
1407482730
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ELITE CLINICAL CARE PHARMACY INC
Doing business as
Elite Clinical Care Pharmacy
Practice address
9103 Sepulveda Blvd
North Hills, CA 91343-3920
Phone
(818) 724-8111
Fax
(818) 875-2057
NPI assigned
Mar 18, 2020
Last updated
Mar 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Authorized official

Name
Mrs. Christine A Gabrielian, PHARM DNPI 1033423256
Title
President/Pic
Phone
(818) 724-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

9103 Sepulveda Blvd
North Hills, CA 91343-3920

Mailing address

9103 Sepulveda Blvd
North Hills, CA 91343-3920
Phone (818) 724-8111

Other identifiers 1

IdentifierTypeStateIssuer
57477OtherCABOARD OF PHARMACY PERMIT

Other names 1

  • ELITE CLINICAL CARE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200924002136 CA DME Supplier - Pharmacy 8527487552 Practice locations: North Hills, CA
O20201222002966 CA Part B Supplier - Mass Immunization (Roster Biller Only) 8527487552 Practice locations: North Hills, CA

National Provider Directory

National Provider Directory
Tax ID family
Elite Clinical Care Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1407482730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9103 SEPULVEDA BLVD",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913433920",
            "telephone_number": "818-724-8111",
            "fax_number": "818-875-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9103 SEPULVEDA BLVD",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913433920",
            "telephone_number": "818-724-8111",
            "fax_number": "818-875-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CLINICAL CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "GABRIELIAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "818-724-8111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "57477",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELITE CLINICAL CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.