Provider Demographics
NPI:1073820486
Name:JAMPEM ENTERPRISE LTD
Entity Type:Organization
Organization Name:JAMPEM ENTERPRISE LTD
Other - Org Name:IMPERIAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OPHELIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EMEAKOROHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-277-0612
Mailing Address - Street 1:1211 STATE HWY 6
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4941
Mailing Address - Country:US
Mailing Address - Phone:281-277-0612
Mailing Address - Fax:281-277-0652
Practice Address - Street 1:1211 STATE HWY 6
Practice Address - Street 2:STE 110
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4941
Practice Address - Country:US
Practice Address - Phone:281-277-0612
Practice Address - Fax:281-277-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid