Provider Demographics
NPI:1215250287
Name:SALLEY, EMILY B (RPH)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:B
Last Name:SALLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-3184
Mailing Address - Country:US
Mailing Address - Phone:888-892-9001
Mailing Address - Fax:866-554-9620
Practice Address - Street 1:221 PLAZA DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-3184
Practice Address - Country:US
Practice Address - Phone:888-892-9001
Practice Address - Fax:866-554-9620
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist