Jeffrey B Emmons, RPH
Individual provider Active NPI Pharmacist · Grayling, MI
NPI 1467733485 · NPPES record last updated Sep 3, 2011
Key facts
- NPI
- 1467733485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302025376 (MI)
- Practice address
- 2045 S I 75 Business Loop
Grayling, MI 49738-2039 - Phone
- (989) 344-0374
- Fax
- (989) 344-0968
- NPI assigned
- Sep 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302025376 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025376 | MI | Yes |
Addresses
Primary practice location
2045 S I 75 Business Loop
Grayling, MI 49738-2039
Mailing address
2045 S I 75 Business Loop
Grayling, MI 49738-2039
Phone (989) 344-0374
Other providers in Grayling, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.