Pamela Elizabeth Ehlers, BS

Individual provider Active NPI Pharmacist · Red Bud, IL

NPI 1174744882 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1174744882
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
Practice address
1375 S Main St
Red Bud, IL 62278-1352
Phone
(618) 282-2870
Fax
(618) 282-6488
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
051027957ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Groceries of Southern Illinois, LLC. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Yes

Addresses

Primary practice location

1375 S Main St
Red Bud, IL 62278-1352

Mailing address

406 Friendly Dr
Red Bud, IL 62278-1742
Phone (618) 282-3909

Other providers in Red Bud, IL

All providers in Red Bud, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.