Gerald Ellis
Pharmacist, Pharmacotherapy in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1487066676
StatusActive
Last updated in NPPESMay 22, 2014
Details
- NPI
- 1487066676
- Entity type
- Individual (NPI-1)
- Name
- Gerald Ellis
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2014
- Last updated
- May 22, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P1200X | Pharmacist, Pharmacotherapy | 26023966A | IN | Yes |
Other names
- Gerald Ellis (Professional Name)
Practice location
10301 E State Road 37Fort Wayne, IN 46835-9591
Phone 260-492-1333
Mailing address
6206 Twisted Oak CtFort Wayne, IN 46835-2649
Phone 260-402-5429
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 25 Pharmacotherapy Pharmacist providers in Fort Wayne · All 11,302 providers in Fort Wayne
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