# EMERSON PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Loyola Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780936237
- **Authorized official:** JOE KOHAN (TREASURY)
- **Authorized official phone:** (310) 780-2844

## Contact information

- **Practice address:** 8400 LINCOLN BLVD, LOS ANGELES, CA 90045-2416
- **Practice address phone:** (310) 670-3829
- **Practice address fax:** (877) 847-9589
- **Mailing address:** 8400 LINCOLN BLVD, LOS ANGELES, CA 90045-2416
- **Mailing address phone:** (310) 670-3829
- **Mailing address fax:** (877) 847-9589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY48754 | CA | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/09/2012
- **Last updated:** 10/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5645467 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |