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General NPI Number Information
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NPI Number | 1265751481
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Entity Type | Organization
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Legal Business Name | ELOHIM PHARMACEUTICALS LLC
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 8484 FREDERICKSBURG RD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3317
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Country | US
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Telephone | 210-949-0228
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Fax | 210-949-0281
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Provider Business Mailing Address
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Address Line | 8484 FREDERICKSBURG RD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3317
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Country | US
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Telephone | 210-949-0228
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Fax | 210-949-0281
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Authorized Official
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Title or Position | P.I.C
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Name | DR. JOSEPH AGBEBAKU
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Credential | PHARM.D
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Telephone | 210-949-0228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 26592
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License Number State | TX
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