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Organization
EMMANUEL VENTURES LIMITED LLC
Active
Organization
EMMANUEL VENTURES LIMITED LLC
Active
Other names
Severance Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
OPEYEMI ADEWESO RPH (PHARMACIST IN CHARGE)
(216) 691-2369
Entity
Organization
Contact information
Practice address
4127 E 131ST ST, MILES SUPERMARKET, CLEVELAND, OH 44105-5563
(216) 691-2369
(216) 691-3119
Mailing address
4127 E 131ST ST, MILES SUPERMARKET, CLEVELAND, OH 44105-5563
(216) 691-2369
(216) 691-3119
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RTP.022607100-03
OH
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136201
PK
—
Enumeration date
07/25/2012
Last updated
03/30/2017
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