Ellis, Gerald
Ellis, Gerald is an individual health care provider with primary practice located at 10301 E State Road 37 , Fort Wayne IN 46835-9591. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Ellis, Gerald can be contacted via phone (260) 492-1333.Contact Information
Primary practice address
10301 E State Road 37
Fort Wayne IN 46835-9591
Phone: (260) 492-1333
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacotherapy | 1835P1200X | 26023966A | Indiana |
Profile Details
| NPI number | 1487066676 |
|---|---|
| LBN Legal business name | Ellis, Gerald |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2014 |
| Last updated | May 22nd, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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