NPIMap

Organization Active NPI

Elohim Pharmaceuticals LLC

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1003142357
Registry record updated Dec 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
29629 Issued in TX
Legal business name
ELOHIM PHARMACEUTICALS LLC
Practice address
11329 Bissonnet St
Houston, TX 77099-2049
Phone
(346) 888-6000
Fax
(713) 827-1704
NPI assigned
Oct 21, 2009
Organization subpart
Yes
Parent organization
ELOHIM PHARMACEUTICALS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joseph Agbebaku, PHARMD
Title
P.I.C
Phone
(346) 888-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 29629 TX Primary

Addresses

Primary practice location

11329 Bissonnet St
Houston, TX 77099-2049

Mailing address

11329 Bissonnet St
Houston, TX 77099-2049
Phone (346) 888-6000

Other identifiers 1

IdentifierTypeStateIssuer
.146082MedicaidTX

Other names 1

  • Eagle Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elohim Pharmaceuticals LLC2 organizations share this tax ID, including this one
Part of
Elohim Pharmaceuticals LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11329 Bissonnet St
Houston, TX 77099
Phone (346) 888-6000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1003142357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11329 BISSONNET ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992049",
            "telephone_number": "346-888-6000",
            "fax_number": "713-827-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11329 BISSONNET ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992049",
            "telephone_number": "346-888-6000",
            "fax_number": "713-827-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELOHIM PHARMACEUTICALS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELOHIM PHARMACEUTICALS LLC",
        "enumeration_date": "2009-10-21",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "AGBEBAKU",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "P.I.C",
        "authorized_official_telephone_number": "346-888-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": ".146082",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.