CHARLES ELLERMAN (NPI# 1932709151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932709151 |
| Entity Type | Individual |
| Full Name | CHARLES ELLERMAN |
| Practice Address |
2610 W Haven Rd Lawrenceville IL 62439-3345 |
| Mailing Address |
1803 S Lost Rd Monroe City IN 47557-7315 |
| Practice Telephone | 6189435515 |
| Mailing Telephone | 8128874259 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 051.293163 | IL | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 26022434A | IN | Pharmacy Service Providers |
| Street Address |
2610 W HAVEN RD |
| City | LAWRENCEVILLE |
| State | IL |
| Zip Code | 62439-3345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942227228 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2610 W Haven Rd, Lawrenceville, IL 62439-3345 | 2006-07-16 |
| 1518567114 | Anne Augustine Rickert | Pharmacist | 2610 W Haven Rd, Lawrenceville, IL 62439-3345 | 2020-11-01 |
| 1427658582 | Charles M Grimes | Pharmacy | 2610 W Haven Rd, Lawrenceville, IL 62439-3345 | 2020-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406590 | Allyson Fiscus | Nurse Practitioner | 11020 Il-250, Lawrenceville, IL 62439 | 2020-08-06 |
| 1164071700 | Lauren E Welton | Case Manager/Care Coordinator | 11362 Country Club Road, Lawrenceville, IL 62439 | 2019-09-06 |
| 1962063354 | Connie Deckard | Counselor | Lawrence County Health Department Behavior Health, 11020 State Route 250, Lawrenceville, IL 62439 | 2019-06-26 |
| 1225485527 | Megan Joergens | Social Worker | 11120 State Route 250, Lawrenceville, IL 62439 | 2016-05-17 |
| 1235509456 | Christy M Wimberly | Private Vehicle | 1417 Dubios St., Lawrenceville, IL 62439 | 2015-09-30 |
| 1144637521 | Joy Singson Uy | Physical Therapist | 2101 James St United Methodist Village North, Lawrenceville, IL 62439 | 2014-07-17 |
| 1760791792 | Lawrence Co | Secured Medical Transport (VAN) | 2009 Lexington Ave, Lawrenceville, IL 62439 | 2010-09-24 |
| 1134358922 | Lawrence County Health Department | Public Health or Welfare | Rural Route3 Box 430, Lawrenceville, IL 62439 | 2009-07-14 |
| 1366678161 | Judith Joan Phipps | Counselor | Rr1 Box 277, Lawrenceville, IL 62439 | 2009-06-08 |
| 1366648784 | S. Hurn Baek | Radiology | Lawrence County Memorial Hospital, Radiology, 2200 W. State St., Lawrenceville, IL 62439 | 2007-06-22 |
| Find all providers in zip 62439 | ||||
| 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 |
|---|---|---|---|---|
| 1851990394 | Emmanuel Dingsangha | Pharmacist | 3324 Shady Woods Cir, Lawrenceville, GA 30044-2569 | 2020-10-24 |
| 1700404670 | Abel E Kusovschi | Pharmacist | 146 Lancelot Way, Lawrenceville, GA 30046-4756 | 2020-07-08 |
| 1699339374 | Kimberly Woodruff | Pharmacist | 1 Old Bridle Path, Lawrenceville, NJ 08648-1080 | 2019-04-28 |
| 1063920668 | Elizabeth Darbee | Pharmacist | 68 Hopatcong Dr, Lawrenceville, NJ 08648-4136 | 2018-01-17 |
| 1952829368 | Shannon Alexander | Pharmacist | 2780 Commons Dr, Lawrenceville, GA 30044-5761 | 2017-09-06 |
| 1467992289 | Stephanie J Henklein | Pharmacist | 3197 River Oak Ct, Lawrenceville, GA 30044-5650 | 2017-02-27 |
| 1396282125 | Bhumika Dhanani | Pharmacist | 1600 Creek Pointe Cir, Lawrenceville, GA 30043-8355 | 2017-01-31 |
| 1811446511 | Niki J Patel | Pharmacist | 9 Dix Ln, Lawrenceville, NJ 08648-4844 | 2016-09-23 |
| 1891158382 | Justin George | Pharmacist | 1179 Ridge Hollow Lane, Lawrenceville, GA 30043 | 2016-04-01 |
| 1770956153 | Deepika Choudhri | Pharmacist | 315 Stratford Dr, Lawrenceville, NJ 08648-1251 | 2015-11-05 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 62439 |
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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.