Emmanuel Awah

Individual provider Active NPI Pharmacist · Lebanon, KY

NPI 1992446579 · NPPES record last updated Apr 6, 2022

Key facts

NPI
1992446579
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
019648 (KY)
Practice address
512 W Main St
Lebanon, KY 40033-1339
Phone
(270) 692-0471
NPI assigned
Apr 6, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
019648KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Current
since Apr 10, 2022
Accepting new patients
Walgreen Co Past
since Apr 10, 2022
Accepting new patients

Locations

512 W Main St
Lebanon, KY 40033
Phone (270) 692-0471

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019648 KY Yes

Addresses

Primary practice location

512 W Main St
Lebanon, KY 40033-1339

Mailing address

512 W Main St
Lebanon, KY 40033-1339
Phone (270) 692-0471

Other providers in Lebanon, KY

All providers in Lebanon, KY · Pharmacist in Kentucky

Sources for this page

Verify at the official NPI Registry.