DR. CHARLES K ELLIS (NPI# 1124366703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124366703 |
| Entity Type | Individual |
| Full Name | DR. CHARLES K ELLIS |
| Credential | PHARM D |
| Practice Address |
2040 Shepherd Rd Mulberry FL 33860-8699 |
| Practice Telephone | 8636445929 |
| Mailing Telephone | 8636445929 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS32584 | FL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164827929 | Charles Ellis | Pharmacist | 534 S 5th St W, Missoula, MT 59801-2618 | 2014-10-22 |
| 1922230010 | Charles Carlisle Ellis | Speech-Language Pathologist | 14015 Santa Fe Ct, Bakersfield, CA 93314-8357 | 2009-08-22 |
| 1124196845 | Charles T. Ellis | Psychiatry & Neurology | 2600 Winny Ave., Helena, MT 59601 | 2006-12-01 |
| 1427131572 | Charles H. Ellis | Dentist | 6930 Cahaba Valley Rd, Suite 1, Birmingham, AL 35242-2672 | 2006-10-23 |
| 1013098698 | Charles Lee Ellis | Dentist | 1107 S Fifth St Ste 250, Mebane, NC 27302-9896 | 2006-10-18 |
| 1215017009 | Charles Ellis | Counselor | 5130 S. Pecos Road, Suite 2b, Las Vegas, NV 89120 | 2006-10-16 |
| 1134165343 | Charles Michael Ellis | Physical Therapist | 2000 Berry Chase Pl, Montgomery, AL 36117-6896 | 2006-06-22 |
| 1861447088 | Charles E Ellis | Nurse Anesthetist, Certified Registered | 165 Sabal Ln, Englewood, FL 34223-5938 | 2006-05-24 |
| 1881222669 | Charles Ellis | Urology | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2020-03-29 |
| 1184020968 | Charles Ellis Jr. | Counselor | 5130 S Pecos Rd, Las Vegas, NV 89120-1201 | 2014-11-06 |
| Street Address |
2040 SHEPHERD RD |
| City | MULBERRY |
| State | FL |
| Zip Code | 33860-8699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437198306 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2006-06-06 |
| 1548806110 | William Cortes | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2019-11-19 |
| 1962867291 | John Johnson | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2015-12-31 |
| 1518376052 | Randi Krouskos | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2014-08-08 |
| 1053658187 | Bridget Ross | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2013-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598280414 | Marilyn Renee Hobdy | Case Manager/Care Coordinator | 2155 Pump Rd, Mulberry, FL 33860 | 2017-08-11 |
| 1467902353 | Healthstat Onsite Clinic Mosaic South Pierce | Preventive Medicine | 7450 Hwy 630, Mulberry, FL 33860 | 2016-10-04 |
| 1356740757 | Healthstat Onsite Clinic- Mosaic Mulberry | Preventive Medicine | 3095 Highway 640 West, Mulberry, FL 33860 | 2014-08-21 |
| 1154746899 | Central Florida Health Care, Inc. | Clinic/Center | 106 Nw 9th Avenue, Mulberry, FL 33860 | 2014-03-04 |
| 1114056108 | Abhaykumar Sobhagchand Shah | Pharmacist | 6745 North Curch Ave, Mulberry, FL 33860 | 2007-03-05 |
| 1174134845 | Mulberry Ltc Pharmacy, LLC | Pharmacy | 1011 N Church Ave, Mulberry, FL 33860 | 2020-08-14 |
| 1609112408 | Margarette Lespinasse | Nurse Practitioner | 106 Nw 9th Ave, Mulberry, FL 33860 | 2012-12-26 |
| 1437141686 | Salazar Family Health Care, Inc | Family Medicine | 708 N Church Ave, Mulberry, FL 33860-2034 | 2005-08-15 |
| 1811357775 | Sandra George | Nurse Practitioner | 708 N Church Ave, Mulberry, FL 33860-2034 | 2016-03-03 |
| 1417588625 | Mulberry Food and Pharmacy LLC | Pharmacy | 806 N Church Ave, Mulberry, FL 33860-2036 | 2020-01-28 |
| Find all providers in zip 33860 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922556570 | Viviana Paola Myers | Pharmacist | 4420 Starlight Pointe Dr, Mulberry, FL 33860-4519 | 2016-09-12 |
| 1316190481 | Derek Eugene Dixon | Pharmacist | 3666 Starburst Ct, Mulberry, FL 33860-8526 | 2008-11-02 |
| 1114056108 | Abhaykumar Sobhagchand Shah | Pharmacist | 6745 North Curch Ave, Mulberry, FL 33860 | 2007-03-05 |
| 1790386548 | Cruz Migdalia Nieves | Pharmacist | 6745 N Church Ave, Mulberry, FL 33860-2080 | 2020-11-06 |
| 1386244564 | Rakesh M Patel | Pharmacist | 6745 N Church Ave, Mulberry, FL 33860-2080 | 2020-10-28 |
| 1518586585 | Laurie Ann Sweeney | Pharmacist | 106 Nw 9th Ave, Mulberry, FL 33860-2922 | 2020-04-10 |
| 1548806110 | William Cortes | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2019-11-19 |
| 1962867291 | John Johnson | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2015-12-31 |
| 1518376052 | Randi Krouskos | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2014-08-08 |
| 1053658187 | Bridget Ross | Pharmacist | 2040 Shepherd Rd, Mulberry, FL 33860-8699 | 2013-01-09 |
| Find all providers in MULBERRY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.