Ellis, Rose

Ellis, Rose is an individual health care provider with primary practice located at 1800 N California St Home Infusion Pharmacy, Stockton CA 95204-6019. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Nutrition Support. Pharmacy Service Providers / Pharmacist is her primary health care specialty. Ellis, Rose can be contacted via phone (209) 461-5486.

Contact Information

Primary practice address
1800 N California St Home Infusion Pharmacy Stockton CA 95204-6019
Phone: (209) 461-5486
Fax: (209) 461-6890
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 30597 California
Pharmacy Service Providers / Nutrition Support 1835N1003X 30597 California

Profile Details

NPI number 1750363636
LBN Legal business name Ellis, Rose
Credentials R.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1750363636 NPPES
California Other 30597 CALIF. LICENSE NUMBER

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