Individual provider Active NPI

Angela Marie Eller

  • Pharmacist
  • Erie, PA
National Provider Identifier
1114471778
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP448248 Issued in PA
Practice address
5035 Peach St
Erie, PA 16509-2013
Phone
(814) 480-7789
NPI assigned
Aug 11, 2016
Last updated
Dec 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP448248 PA Primary

Addresses

Primary practice location

5035 Peach St
Erie, PA 16509-2013

Mailing address

5035 Peach St
Erie, PA 16509-2013
Phone (814) 480-7789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP448248PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Associates of Erie PC Current Accepting new patients
OB-GYN Associates of Erie, PC Current Accepting new patients
Bayside Pharmacy Limited Partnership PastSince Apr 25, 2021 Accepting new patients

Locations

5035 Peach St
Erie, PA 16509
Phone (814) 480-7789

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1114471778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092013",
            "telephone_number": "814-480-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092013",
            "telephone_number": "814-480-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2022-12-08",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP448248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.