Organization
PATHWAY PHARMACEUTICALS INC.
Active
Other names
La Quinta Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ADEYEMI OMILANA (PRESIDENT/PHARMACIST)
(760) 346-1113
Entity
Organization
Contact information
Practice address
43875 WASHINGTON ST STE A, PALM DESERT, CA 92211-8249
(760) 777-9902
(760) 777-9820
Mailing address
43875 WASHINGTON ST, SUITE A, PALM DESERT, CA 92211-8249
(760) 777-9902
(760) 777-9820
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51682
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141798
PK
—
Enumeration date
12/19/2013
Last updated
12/19/2013
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