Emmanuel Douah, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

117100 Issued in MN

Practice address

612 4TH Avenue NW
Faribault, MN 55021

Phone

(507) 332-9783

NPI assigned

Dec 2, 2011

Last updated

Dec 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1164790374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 PHEASANTWOOD TRL",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573019",
            "telephone_number": "612-229-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 4TH AVENUE NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-332-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUAH",
        "first_name": "EMMANUEL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117100",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "245453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Binto Diriye
• Discovery Public School of Faribault
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• Alexus Nicole Donkers
• Tasha Dornquast
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• Dr. Robert J. Erickson, P.a.
• Dr. Warren Johnson, DDS
• Kris W Drevlow, DO
• Elizabeth K Drewitz, PSYD, LP

• Pharmacist in Faribault, MN
• Providers in Faribault, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.