Provider Demographics
NPI:1740732957
Name:ANINKORAH-YEBOAH, KWESI (PHARMD)
Entity type:Individual
Prefix:
First Name:KWESI
Middle Name:
Last Name:ANINKORAH-YEBOAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-1791
Mailing Address - Country:US
Mailing Address - Phone:870-735-8987
Mailing Address - Fax:
Practice Address - Street 1:1800 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1791
Practice Address - Country:US
Practice Address - Phone:870-735-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD13849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist