Organization Active NPI

Emmanuel Chuks Obi

Doing business as Good Shepard Pharmacy

  • Community/Retail Pharmacy
  • El Paso, TX
National Provider Identifier
1609875541
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
19621 Issued in TX
Legal business name
EMMANUEL CHUKS OBI
Doing business as
Good Shepard Pharmacy
Practice address
5301 Alameda Ave
El Paso, TX 79905-2805
Phone
(915) 542-3880
Fax
(915) 772-4844
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Emmanuel Obi, RPH
Title
Owner and Ceo
Phone
(915) 542-3880

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 19621 TX Primary

Addresses

Primary practice location

5301 Alameda Ave
El Paso, TX 79905-2805

Mailing address

5301 Alameda Ave
El Paso, TX 79905-2805
Phone (915) 542-3880

Other identifiers 3

IdentifierTypeStateIssuer
4509216OtherNCPDP PROVIDER IDENTIFICATION NUMBER
144857MedicaidTX
27510MedicaidTX

Other names 1

  • GOOD SHEPARD PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5301 Alameda Ave
El Paso, TX 79905
Phone (915) 542-3880

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1609875541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052805",
            "telephone_number": "915-542-3880",
            "fax_number": "915-772-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052805",
            "telephone_number": "915-542-3880",
            "fax_number": "915-772-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL CHUKS OBI",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "915-542-3880",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "19621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4509216",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144857",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27510",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOOD SHEPARD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.