Elliotts Pharmacy Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

102015 Issued in CA

Legal business name

ELLIOTTS PHARMACY INC.

Doing business as

Maxcare/Maxcare RX

Practice address

4825 El Camino Real
Atascadero, CA 93422-2759

Phone

(888) 900-7878

Fax

(877) 430-7695

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ashe Wahba

Title

Owner/Pharmacist

Phone

(888) 900-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maxcare/Maxcare RX Doing business as

Tax ID family

Elliotts 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.

• Elliotts Pharmacy Inc.

  • Home Infusion Therapy Pharmacy
  • Atascadero, CA
  • NPI 1710902705
  NPD tax ID

Locations

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790721793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934222759",
            "telephone_number": "888-900-7878",
            "fax_number": "877-430-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934222759",
            "telephone_number": "888-900-7878",
            "fax_number": "877-430-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTTS PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAHBA",
        "authorized_official_first_name": "ASHE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "888-900-7878",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "102015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxcare/Maxcare RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tayler Nicole Edwards
• Molly Anne Eisen-Kearns, LCSW
• El Camino Homeless Organization
• Cindy Kang Elliott, M.D.
• Elliotts Pharmacy Inc.
• Izabella Ellis
• Anas Elsaid, M.D
• Todd Stuart Elwyn, M.D.
• David C Emelity, MD
• Candace Ennis

• Durable Medical Equipment & Medical Supplies in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.