MEDICARE: MOHAB HARAKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS53435	FL

General Provider Information

NPI Number	:	1992168892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAB HARAKA

Provider Business Mailing Address
First Line	:	2525 S 28TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-5803
Country	:	US
Telephone Number	:	352-213-3815
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 S 28TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-5803
Country	:	US
Telephone Number	:	352-213-3815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	03/30/2016

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Directions to “ MOHAB HARAKA ” Practice Location

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