NPIMap

Organization Active NPI

Emanate Health Medical Center

  • Community/Retail Pharmacy
  • West Covina, CA
National Provider Identifier
1174301022
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
EMANATE HEALTH MEDICAL CENTER
Practice address
1135 S Sunset Ave Ste 104
West Covina, CA 91790-3965
Phone
(626) 732-8670
Fax
(626) 746-3068
NPI assigned
Sep 20, 2023
Organization subpart
Yes
Parent organization
EMANATE HEALTH MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Rajesh Sharma
Title
President & Ceo
Phone
(626) 938-7595

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1135 S Sunset Ave Ste 104
West Covina, CA 91790-3965

Mailing address

1620 W Northwest Hwy Ste 100
Grapevine, TX 76051-3219
Phone (817) 572-0009

Other names 1

  • Emanate Health Medical Center Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240919000729 CA DME Supplier - Pharmacy 0143317453 Practice locations: West Covina, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Emanate Health Medical Ctr Pharmacy1135 S Sunset Ave, West Covina, CA 91790-3965(626) 732-8670 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Emanate Health Medical Center4 organizations share this tax ID, including this one
Part of
Emanate Health Medical Center

Other organizations with this tax ID 3

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

Locations

315 N 3rd Ave
Ste 203
Covina, CA 91723
Phone (626) 915-6266

1135 S Sunset Ave
Ste 104
West Covina, CA 91790
Phone (626) 732-8670

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1174301022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W NORTHWEST HWY STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513219",
            "telephone_number": "817-572-0009",
            "fax_number": "817-572-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 104",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903965",
            "telephone_number": "626-732-8670",
            "fax_number": "626-746-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMANATE HEALTH MEDICAL CENTER",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "626-938-7595"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emanate Health Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emanate Health Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.