Provider Demographics
NPI:1871196634
Name:YEMETS, MARIYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:YEMETS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6035
Mailing Address - Country:US
Mailing Address - Phone:479-305-8654
Mailing Address - Fax:
Practice Address - Street 1:1308 S ROCK ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-7160
Practice Address - Country:US
Practice Address - Phone:870-942-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist