Healthcare Provider Details

I. General information

NPI: 1306129846
Provider Name (Legal Business Name): EMILI REEVES MCBRIDE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LAFOLLETTE STA S
FLOYDS KNOBS IN
47119-9776
US

IV. Provider business mailing address

3918 HAY MARKET DR
JEFFERSONVILLE IN
47130-8260
US

V. Phone/Fax

Practice location:
  • Phone: 812-923-0291
  • Fax:
Mailing address:
  • Phone: 931-242-1178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26024002A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015391
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33046
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: