Ellis Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY31181 Issued in CA

Legal business name

ELLIS PHARMACY

Practice address

468 Ellis St
San Francisco, CA 94102-1928

Phone

(415) 441-1016

Fax

(415) 441-5088

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Hung DO Pham, R.PHAR.

Title

Pharmacist-in-Charge

Phone

(415) 441-1016

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356553812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 ELLIS ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021928",
            "telephone_number": "415-441-1016",
            "fax_number": "415-441-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 ELLIS ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021928",
            "telephone_number": "415-441-1016",
            "fax_number": "415-441-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "HUNG",
        "authorized_official_middle_name": "DO",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "415-441-1016",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PHAR."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY31181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA311810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristian Elliott
• Lea Mine Chen Elliott
• Mark David Elliott, M.D.
• Megan Elliott, LMFT
• Stephanie Elliott
• Chrystal Ellis Sweazey
• Sarah Ellis-Falik
• Chanel Ellis
• Elaine Barbara Ellis
• John Michael Ellis, L.AC.

• Community/Retail Pharmacy in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.