Organization
EMMANUEL INC
Active
Other names
COLLEGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROB HARKNESS (VP)
(501) 327-8088
Entity
Organization
Contact information
Practice address
2125 COLLEGE AVE, SUITE 1, CONWAY, AR 72034-6210
(501) 327-8088
(501) 730-0220
Mailing address
2125 COLLEGE AVE, SUITE 1, CONWAY, AR 72034-6210
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20149
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0411671
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/06/2007
Last updated
08/31/2007
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