# EMMANUEL VENTURES LIMITED LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Severance Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053667204
- **Authorized official:** OPEYEMI ADEWESO RPH (PHARMACIST IN CHARGE)
- **Authorized official phone:** (216) 691-2369

## Contact information

- **Practice address:** 4127 E 131ST ST, MILES SUPERMARKET, CLEVELAND, OH 44105-5563
- **Practice address phone:** (216) 691-2369
- **Practice address fax:** (216) 691-3119
- **Mailing address:** 4127 E 131ST ST, MILES SUPERMARKET, CLEVELAND, OH 44105-5563
- **Mailing address phone:** (216) 691-2369
- **Mailing address fax:** (216) 691-3119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RTP.022607100-03 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 03/30/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2136201 | PK | — |