Provider Demographics
NPI:1407451412
Name:EMERY, JENNY (RPH)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E BOONVILLE NEW HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-1102
Mailing Address - Country:US
Mailing Address - Phone:812-867-6407
Mailing Address - Fax:812-867-6453
Practice Address - Street 1:511 E BOONVILLE NEW HARMONY RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-1102
Practice Address - Country:US
Practice Address - Phone:812-867-6407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019663A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist