Provider Demographics
NPI:1114354537
Name:EMERLING INC
Entity Type:Organization
Organization Name:EMERLING INC
Other - Org Name:MEDICINE SHOPPE 659
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-824-2288
Mailing Address - Street 1:102 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62568-1547
Mailing Address - Country:US
Mailing Address - Phone:217-824-2288
Mailing Address - Fax:217-287-7422
Practice Address - Street 1:102 W PARK ST
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568-1547
Practice Address - Country:US
Practice Address - Phone:217-824-2288
Practice Address - Fax:217-287-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332100000X, 333600000X
IL054.0184453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2143958OtherPK