Organization
EMMANUEL CHUKS OBI
Active
Other names
GOOD SHEPARD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL OBI RPH (OWNER AND CEO)
(915) 542-3880
Entity
Organization
Contact information
Practice address
5301 ALAMEDA AVE, EL PASO, TX 79905-2805
(915) 542-3880
(915) 772-4844
Mailing address
5301 ALAMEDA AVE, EL PASO, TX 79905-2805
(915) 542-3880
(915) 772-4844
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19621
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144857
—
TX
05
—
27510
—
TX
01
—
4509216
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/20/2005
Last updated
08/03/2011
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