Mr Mark Aldor Ellingson, RPH is a
Pharmacist based in Osburn, Idaho. Mr Mark Aldor Ellingson is licensed to practice in Idaho (license number P7037) and his current practice location is
805 Mullan Avenue, Box 2170, Osburn, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 752-1028.
NPI number for Mr Mark Aldor Ellingson is 1659768034 and his current mailing address is 805 Mullan Avenue, Osburn, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1659768034.
Healthcare Provider's Profile
| Full Name | Mr Mark Aldor Ellingson |
|---|
| Gender | Male |
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| Speciality | Pharmacist |
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| Location | 805 Mullan Avenue, Osburn, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1659768034
- Provider Enumeration Date: 04/23/2015
- Last Update Date: 04/23/2015
Medical Identifiers
Medical identifiers for Mr Mark Aldor Ellingson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659768034 | NPI | - | NPPES |
| 002450000 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | P7037 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Aldor Ellingson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Mark Aldor Ellingson, RPH
805 Mullan Avenue,
Osburn, ID 83849
Ph: (208) 752-1028 | Mr Mark Aldor Ellingson, RPH
805 Mullan Avenue, Box 2170,
Osburn, ID 83849
Ph: (208) 752-1028 |
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