Tonya Leigh Ellis, PHARMD.
Individual provider Active NPI Pharmacist · Lula, GA
NPI 1760448138 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760448138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH020842 (GA)
- Practice address
- 6102 Banks St
Lula, GA 30554-2858 - Phone
- (770) 869-3616
- Fax
- (770) 869-9080
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH020842 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmaceutical Concepts PC | Past |
Accepting new patients | |
| Pharmaceutical Concepts PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH020842 | GA | Yes |
Addresses
Primary practice location
6102 Banks St
Lula, GA 30554-2858
Mailing address
6675 Twin Mountain PT
Clermont, GA 30527-1846
Phone (770) 983-5758
Other providers in Lula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.