Organization
HERRAKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IHAB HERRAKA MD (OWNER)
(352) 871-0992
Entity
Organization
Contact information
Practice address
3416 OLD GREENWOOD RD, FORT SMITH, AR 72903-5462
(479) 242-2888
(479) 242-2889
Mailing address
3416 OLD GREENWOOD RD, FORT SMITH, AR 72903-5462
(352) 871-0992
(479) 242-2889
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-7210
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193771001
—
AR
05
—
200449360A
—
OK
Enumeration date
01/30/2015
Last updated
07/13/2015
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