Pathway Pharmaceuticals Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY47407 Issued in CA

Legal business name

PATHWAY PHARMACEUTICALS INC

Practice address

73847 Highway 111
Palm Desert, CA 92260-4005

Phone

(760) 346-1113

Fax

(760) 346-8725

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Adeyemi Omilana, RPH

Title

Owner

Phone

(760) 409-4898

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• FIRESIDE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1629140405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73847 HIGHWAY 111",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604005",
            "telephone_number": "760-346-1113",
            "fax_number": "760-346-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73847 HIGHWAY 111",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604005",
            "telephone_number": "760-346-1113",
            "fax_number": "760-346-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY PHARMACEUTICALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "OMILANA",
        "authorized_official_first_name": "ADEYEMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-409-4898",
        "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": "CA",
            "license": "PHY47407",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA474070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067075",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRESIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neil Sunit Patel, DDS
• Reena Patel, DDS
• Riddhi Patel, PHARM.D.
• Sara Patel
• Diptee Pathak, PT, DPT
• Pathway Pharmaceuticals Inc.
• Soniya Patidar, DMD
• Patricia L. James, M.D. , Inc.
• Monica Paz, HIGH SCHOOL DIPLOMA
• Pearle Visioncare, Inc

• 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 Jan 19, 2017; 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.