Emmanuel Pharmacy Corp.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

51507 Issued in CA

Legal business name

EMMANUEL PHARMACY CORP.

Practice address

77760 Country Club Dr
Suite I
Palm Desert, CA 92211-6247

Phone

(760) 360-1080

Fax

(760) 360-1085

NPI assigned

Jul 4, 2013

Organization subpart

No

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

Authorized official

Name

Walid Ibrahim

Title

Ceo

Phone

(760) 835-9888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1053751024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77760 COUNTRY CLUB DR",
            "address_2": "SUITE I",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116247",
            "telephone_number": "760-360-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77760 COUNTRY CLUB DR",
            "address_2": "SUITE I",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116247",
            "telephone_number": "760-360-1080",
            "fax_number": "760-360-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL PHARMACY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-04",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "WALID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-835-9888"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "51507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly A Ellis, LCSW
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• Empire Physicians Medical Group
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• Daniel K Eng, O.D.
• Jan C Engelbrecht
• Greg Engelien, PHARMD

• Community/Retail Pharmacy in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.