Ellis, Rose
Ellis, Rose is an individual health care provider with primary practice located at 1800 N California St Home Infusion Pharmacy, Stockton CA 95204-6019. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Nutrition Support. Pharmacy Service Providers / Nutrition Support is her primary health care specialty. Ellis, Rose can be contacted via phone (209) 461-5486.Contact Information
Primary practice address
1800 N California St Home Infusion Pharmacy
Stockton CA 95204-6019
Phone: (209) 461-5486
Fax: (209) 461-6890
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 30597 | California |
| Pharmacy Service Providers / Nutrition Support | 1835N1003X | 30597 | California |
Profile Details
| NPI number | 1750363636 |
|---|---|
| LBN Legal business name | Ellis, Rose |
| Credentials | R.PH. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2005 |
| Last updated | Sep 11th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750363636 | NPPES |
| California | Other | 30597 | CALIF. LICENSE NUMBER |
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