Organization
PATHWAY PHARMACEUTICALS INC
Active
Other names
LAS PALMAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ADEYEMI OMILANA RPH (PHARMACIST IN CHARGE/OWNER)
(760) 416-0830
Entity
Organization
Contact information
Practice address
555 E TACHEVAH DR STE 1W101, PALM SPRINGS, CA 92262-5772
(760) 416-0830
(760) 416-0832
Mailing address
555 E TACHEVAH DR STE 1W101, PALM SPRINGS, CA 92262-5772
(760) 416-0830
(760) 416-0832
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY45912
CA
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2004895
PK
—
Enumeration date
08/10/2006
Last updated
07/19/2018
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