Organization
ELITEMED, INC.
Active
Other names
MEDBRIDGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ADRINEH KESHISH PHARM D (PRESIDENT/CEO)
(747) 600-9555
Entity
Organization
Contact information
Practice address
10515 BALBOA BLVD STE 125, GRANADA HILLS, CA 91344-6354
(747) 600-9555
(747) 600-8866
Mailing address
10515 BALBOA BLVD STE 125, GRANADA HILLS, CA 91344-6354
(747) 600-9555
(747) 600-8866
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59196
BOARD OF PHARMACY
CA
Enumeration date
01/10/2024
Last updated
01/10/2024
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