Active NPI
Elohim Pharmaceuticals LLC
Doing business as Eagle Pharmacy
- Pharmacy
- San Antonio, TX
National Provider Identifier
1265751481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 26592
- Legal business name
- ELOHIM PHARMACEUTICALS LLC
- Doing business as
- Eagle Pharmacy
- Practice address
- 8484 Fredericksburg Rd
San Antonio, TX 78229-3317 - Phone
- (210) 949-0228
- Fax
- (210) 949-0281
- NPI assigned
- May 27, 2010
- Last updated
- May 27, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joseph Agbebaku, PHARM.D
- Title
- P.I.C
- Phone
- (210) 949-0228
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 26592 | TX | Primary |
Addresses
Primary practice location
8484 Fredericksburg Rd
San Antonio, TX 78229-3317
Mailing address
8484 Fredericksburg Rd
San Antonio, TX 78229-3317
Phone (210) 949-0228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146082 | Medicaid | TX |
Other names 1
- Eagle Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Elohim Pharmaceuticals LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
8484 Fredericksburg Rd
San Antonio, TX 78229
Phone (210) 949-0228
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1274918400000",
"number": "1265751481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8484 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293317",
"telephone_number": "210-949-0228",
"fax_number": "210-949-0281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8484 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293317",
"telephone_number": "210-949-0228",
"fax_number": "210-949-0281"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELOHIM PHARMACEUTICALS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-27",
"last_updated": "2010-05-27",
"status": "A",
"authorized_official_last_name": "AGBEBAKU",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "P.I.C",
"authorized_official_telephone_number": "210-949-0228",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "26592",
"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"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.