Ocotillo Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46532 Issued in CA

Legal business name

OCOTILLO PHARMACY, INC.

Doing business as

Brawley Pharmacy

Practice address

196 W Legion Rd # B
Brawley, CA 92227-7713

Phone

(760) 344-4100

Fax

(760) 344-9100

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Gelman, RPH

Title

President/Owner

Phone

(760) 554-6940

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Brawley Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1487747002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 W LEGION RD # B",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277713",
            "telephone_number": "760-344-4100",
            "fax_number": "760-344-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 W LEGION RD # B",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277713",
            "telephone_number": "760-344-4100",
            "fax_number": "760-344-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "GELMAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "760-554-6940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "PHA465320",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "PHA46520",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA465320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5627609",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brawley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elena Cruz Niebel, NURSE PRACTITIONER
• Theresa Marie Nolan, CRNA
• Christina Ferrel Noriega, FNP
• Brian Craig O'Hair, CRNA
• Ocotillo Pharmacy
• Matthew Ogle
• Diego Ojeda
• Osagie Bello MD Inc.
• Oscar a Lopez MD
• Jessica G Ovando

• Community/Retail Pharmacy in Brawley, CA
• Providers in Brawley, 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 Feb 25, 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.