Provider Demographics
NPI:1225693203
Name:EMPIRE PHARMACEUTICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:EMPIRE PHARMACEUTICAL ASSOCIATES, INC
Other - Org Name:EMPIRE HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-240-8972
Mailing Address - Street 1:295 W CROMWELL AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6167
Mailing Address - Country:US
Mailing Address - Phone:559-240-8972
Mailing Address - Fax:
Practice Address - Street 1:295 W CROMWELL AVE STE 116
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6167
Practice Address - Country:US
Practice Address - Phone:559-240-8972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1558564120Medicaid