10TH Avenue Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

RPH38205 Issued in CA

Legal business name

10TH AVENUE PHARMACY

Practice address

2706 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2747

Phone

(323) 298-7693

Fax

(323) 298-0443

NPI assigned

Jun 29, 2017

Last updated

Jun 29, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Emmanuel C. AcholonuNPI 1689700122

Title

Director

Phone

(323) 298-7693

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emmanuel Acholonu

  • Pharmacist
  • Los Angeles, CA
  • NPI 1689700122
  NPD (past) Authorized official

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1649791633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082747",
            "telephone_number": "323-298-7693",
            "fax_number": "323-298-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "10TH AVENUE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "ACHOLONU",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-298-7693",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "RPH38205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.