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Organization

ELITE RX COMPOUNDING AND PHARMACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FATIMA ELLIS-OTOO PHARM.D. (MANAGER)
(513) 407-2867
Entity
Organization

Contact information

Practice address
8035 HIGHWAY 6 STE 130, MISSOURI CITY, TX 77459-2818
(281) 915-2166
(281) 915-2164
Mailing address
12220 HARMONY HALL CT, PEARLAND, TX 77584-4418

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy
3336M0002X
Mail Order Pharmacy

Other

Enumeration date
08/16/2021
Last updated
01/20/2022
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