Healthcare Provider Details

I. General information

NPI: 1124801741
Provider Name (Legal Business Name): EMILY RENEE FOLEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 W MAIN ST
PERU IN
46970-1741
US

IV. Provider business mailing address

930 W MAIN ST
PERU IN
46970-1741
US

V. Phone/Fax

Practice location:
  • Phone: 765-473-2076
  • Fax:
Mailing address:
  • Phone: 765-473-2076
  • Fax: 765-473-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26030390A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: