Provider Demographics
NPI:1205420478
Name:DESIRE PHARMACY INC
Entity type:Organization
Organization Name:DESIRE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMEAKOROHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-228-2072
Mailing Address - Street 1:5631 TELEPHONE RD STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-4485
Mailing Address - Country:US
Mailing Address - Phone:713-993-6580
Mailing Address - Fax:713-993-6056
Practice Address - Street 1:5631 TELEPHONE RD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4485
Practice Address - Country:US
Practice Address - Phone:713-993-6580
Practice Address - Fax:713-993-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33652OtherTEXAS STATE BOARD OF PHARMACY