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Individual

PATRI ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
403 S CHURCH AVE, LOUISVILLE, MS 39339-2921
(662) 773-7847
(662) 773-7844
Mailing address
403 S CHURCH AVE, LOUISVILLE, MS 39339-2921
(662) 773-7847
(662) 773-7844

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
01826/01.1
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00030300
MS
01
2514063
NABP NUMBER
MS
Enumeration date
10/12/2006
Last updated
03/07/2023
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