Active NPI
Millie Ann Ellis
- Pharmacy Technician
- Warren, IN
National Provider Identifier
1245441633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 67000393A
- Practice address
- 222 N Wayne St
Warren Pharmacy
Warren, IN 46792 - Phone
- (260) 375-2135
- Fax
- (260) 375-7030
- NPI assigned
- May 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 67000393A | IN | Primary |
Addresses
Primary practice location
222 N Wayne St
Warren Pharmacy
Warren, IN 46792
Mailing address
210 E Max Dr
Pennville, IN 47369
Phone (260) 731-5761
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
| License | State | Type | Specialty |
|---|---|---|---|
| 67000393A | IN | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terry R Daniels | Past | Accepting new patients |
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, 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": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245441633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 E MAX DR",
"city": "PENNVILLE",
"state": "IN",
"postal_code": "47369",
"telephone_number": "260-731-5761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 N WAYNE ST",
"address_2": "WARREN PHARMACY",
"city": "WARREN",
"state": "IN",
"postal_code": "46792",
"telephone_number": "260-375-2135",
"fax_number": "260-375-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "MILLIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IN",
"license": "67000393A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.