Provider Demographics
NPI:1639425911
Name:EMERY, DANIEL LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:EMERY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 NUGGET DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7614
Mailing Address - Country:US
Mailing Address - Phone:270-237-0260
Mailing Address - Fax:
Practice Address - Street 1:1405 NASHVILLE ST STE A
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-8850
Practice Address - Country:US
Practice Address - Phone:270-725-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist