Individual
TIMOTHY MICHAEL ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
26 LAURELHART LN, SIMPSONVILLE, SC 29281-3909
(864) 714-9899
Mailing address
26 LAURELHART LANE, SIMPSONVILLE, SC 29681
(864) 714-9899
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13922
SC
183500000X
Pharmacist
22700
NC
Other
Enumeration date
07/05/2012
Last updated
10/03/2021
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