Provider Demographics
NPI:1790380624
Name:AKOTO, EMMANUEL DARKO
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:DARKO
Last Name:AKOTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 LYNNFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5229
Mailing Address - Country:US
Mailing Address - Phone:978-531-6953
Mailing Address - Fax:
Practice Address - Street 1:85 LYNNFIELD ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5229
Practice Address - Country:US
Practice Address - Phone:978-531-6953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist