Emily Jane Koenemann, PHARMD
Individual provider Active NPI Pharmacist · Garrett, IN
NPI 1992345839 · NPPES record last updated Jan 8, 2020
Key facts
- NPI
- 1992345839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26022154A (IN)
- Practice address
- 1350 S Randolph St
Garrett, IN 46738-1971 - Phone
- (260) 553-9200
- NPI assigned
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26022154A | IN | MD | Pharmacist |
| 5302034007 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dekalb Memorial Pharmacare LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302034007 | MI | |
| Pharmacist | 183500000X | 26022154A | IN | Yes |
Addresses
Primary practice location
1350 S Randolph St
Garrett, IN 46738-1971
Mailing address
7430 Clingmans TRL
Fort Wayne, IN 46835-1418
Phone (269) 929-8111
Other providers in Garrett, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2020. 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.