Individual
CHARLES ELLERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2610 W HAVEN RD, LAWRENCEVILLE, IL 62439-3345
(618) 943-5515
Mailing address
1803 S LOST RD, MONROE CITY, IN 47557-7315
(812) 887-4259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.293163
IL
183500000X
Pharmacist
Primary
26022434A
IN
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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