Provider Demographics
NPI:1508478561
Name:EMERSON, VIRGINIA HOUSTON (RPH)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:HOUSTON
Last Name:EMERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:VIRGINIA
Other - Middle Name:HOUSTON
Other - Last Name:EMERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:GINGER
Mailing Address - Street 1:WALGREENS 15785
Mailing Address - Street 2:6068 S FIRST ST
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358
Mailing Address - Country:US
Mailing Address - Phone:731-686-1557
Mailing Address - Fax:731-686-7645
Practice Address - Street 1:WALGREENS 15785
Practice Address - Street 2:6068 S FIRST ST
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358
Practice Address - Country:US
Practice Address - Phone:731-686-1557
Practice Address - Fax:731-686-7645
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist