Organization
JOSEPH R ELLIS
Active
Organization
JOSEPH R ELLIS
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH R. ELLIS (PHARMACIST OWNER)
(901) 363-0750
Entity
Organization
Contact information
Practice address
4770 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3201
(901) 363-0750
(901) 363-0782
Mailing address
4770 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2151
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4426626
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
870023576
MEDICARE (RR)
TN
Enumeration date
08/31/2006
Last updated
03/07/2023
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