Provider Demographics
NPI:1407146608
Name:EMERY, RICHARD LEE (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:EMERY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 BERKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-1487
Mailing Address - Country:US
Mailing Address - Phone:419-433-4420
Mailing Address - Fax:
Practice Address - Street 1:1626 E PERRY ST
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-1332
Practice Address - Country:US
Practice Address - Phone:419-734-5583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03215557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist