Charles Ben Ellis, RPH

Individual provider Active NPI Pharmacist · Cashmere, WA

NPI 1659706299 · NPPES record last updated Sep 12, 2013

Key facts

NPI
1659706299
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PH00010252 (WA)
Practice address
119 Cottage Ave
Cashmere, WA 98815-1001
Phone
(509) 782-2717
Fax
(509) 782-3262
NPI assigned
Sep 12, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00010252WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Pharmacy Inc. Past Accepting new patients
Valley Pharmacy Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00010252 WA Yes

Addresses

Primary practice location

119 Cottage Ave
Cashmere, WA 98815-1001

Mailing address

119 Cottage Ave
Cashmere, WA 98815-1001
Phone (509) 782-2717

Other providers in Cashmere, WA

All providers in Cashmere, WA · Pharmacist in Washington

Sources for this page

Verify at the official NPI Registry.