Organization
EL-ELYON MEDICAL SUPPLY, LLC
Active
Other names
El-Elyon Medical Supply, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEATRICE FEYISETAN (OWNER)
(972) 266-2030
Entity
Organization
Contact information
Practice address
2307 OAK LN, STE # 106, GRAND PRAIRIE, TX 75051-4885
(972) 266-2030
(972) 266-0355
Mailing address
2307 OAK LN, STE # 106, GRAND PRAIRIE, TX 75051-4885
(972) 266-2030
(972) 266-0355
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0083793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169961301
—
TX
05
—
169961302
—
TX
Enumeration date
10/27/2005
Last updated
03/29/2011
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