Search › Idaho › 183500000X
Mark Ellingson, R.PH
NPI 1659768034 · on the registry since 2015
Practice
- Address
- 805 Mullan Avenue
Box 2170
Osburn, ID 83849 - Phone
- (208) 752-1028
- Organisation at this address
- Osburn Drug
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-04-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho