Individual
ROBERT ALLEN ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.
Contact information
Practice address
2759 33RD AVE, COLUMBUS, NE 68601-2327
(402) 564-2883
(402) 563-1272
Mailing address
3930 D RD, BELLWOOD, NE 68624-2491
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8796
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8796
STATE LICENSE NUMBER
NE
Enumeration date
01/17/2007
Last updated
07/08/2007
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