Organization
ELITE CARE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EFOSA OSAGIE (OWNER)
(210) 462-7797
Entity
Organization
Contact information
Practice address
11888 STARCREST DR STE 113, SAN ANTONIO, TX 78247-4116
(210) 462-7797
Mailing address
11888 STARCREST DR STE 113, SAN ANTONIO, TX 78247-4116
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32363
PPO INSURANCE
—
Enumeration date
11/27/2018
Last updated
11/27/2018
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