MEDICARE: PATHWAY PHARMACEUTICALS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336L0003X	Long Term Care Pharmacy
5	3336M0002X	Mail Order Pharmacy
6	3336S0011X	Specialty Pharmacy
7	3336C0003X	Community/Retail Pharmacy	51682	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2141798	OTHER		PK

General Provider Information

NPI Number	:	1932520863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY PHARMACEUTICALS INC.

Provider Business Mailing Address
First Line	:	43875 WASHINGTON ST
Second Line	:	SUITE A
City	:	PALM DESERT
State	:	CA
Zip	:	92211-8249
Country	:	US
Telephone Number	:	760-777-9902
Fax Number	:	760-777-9820

Provider Business Practice Location Address
First Line	:	43875 WASHINGTON ST STE A
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-8249
Country	:	US
Telephone Number	:	760-777-9902
Fax Number	:	760-777-9820

Authorized Official
Title or Position	:	PRESIDENT/PHARMACIST
Name	:	ADEYEMI OMILANA
Credential	:
Telephone Number	:	760-346-1113

Provider Enumeration Date	:	12/19/2013
Last Update Date	:	12/19/2013

Similar Medicare Providers

1174478226 — COACHELLA VALLEY ANGELS, INC.
Practice Location Address:

43875 WASHINGTON ST STE H
PALM DESERT, CA
92211-8249

Practice Phone: 760-404-0220
Practice Fax:

1902907900 — DR. SANDRA ANN BENDER M.D.
Practice Location Address:

43875 WASHINGTON ST STE E
PALM DESERT, CA
92211-8249

Practice Phone: 760-565-6376
Practice Fax: 760-565-6409

1235294893 — PREVENTIVE HEALTH ESSENTIALS INC
Practice Location Address:

43875 WASHINGTON ST , SUITE #C
PALM DESERT, CA
92211-8249

Practice Phone: 951-539-8984
Practice Fax:

1649880790 — INNA VELASQUEZ
Practice Location Address:

43875 WASHINGTON ST STE A
PALM DESERT, CA
92211-8249

Practice Phone: 760-777-9902
Practice Fax:

1427652130 — MRS. ADEBOLA A KOKO FNP
Practice Location Address:

43875 WASHINGTON ST STE C
PALM DESERT, CA
92211-8249

Practice Phone: 833-935-6377
Practice Fax: 833-935-6377

1649861949 — PT WORKS INC
Practice Location Address:

43875 WASHINGTON ST STE G
PALM DESERT, CA
92211-8249

Practice Phone: 760-701-5046
Practice Fax: 888-490-0261

Directions to “PATHWAY PHARMACEUTICALS INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.