Organization
ELEVATE PHARMACY INC
Active
Other names
986 Pharmacy #8018
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA XU (CEO)
(760) 843-7200
Entity
Organization
Contact information
Practice address
12370 HESPERIA RD., #7, VICTORVILLE, CA 92395-7719
(760) 843-7200
(760) 843-7360
Mailing address
12370 HESPERIA RD., #7, VICTORVILLE, CA 92395-7719
(760) 843-7200
(760) 843-7360
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861504797
—
CA
01
—
59201
STATE BOARD OF PHARMACY
CA
Enumeration date
08/31/2006
Last updated
02/21/2025
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