Provider Demographics
NPI:1588289540
Name:EMBERTON, COURTNEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:EMBERTON
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 1:6068 HIGHWAY 110
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031-6137
Mailing Address - Country:US
Mailing Address - Phone:501-253-0051
Mailing Address - Fax:
Practice Address - Street 1:115 COMMONS DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7266
Practice Address - Country:US
Practice Address - Phone:501-803-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist