Provider Demographics
NPI:1093807943
Name:SCHELLHASE, ELLEN MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MICHELLE
Last Name:SCHELLHASE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 10TH ST
Mailing Address - Street 2:W7555 MYERS BLDG WHS
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-753-2024
Mailing Address - Fax:317-613-2316
Practice Address - Street 1:VA MEDICAL CENTER (119)
Practice Address - Street 2:1481 W 10TH STREET
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-613-2315
Practice Address - Fax:317-613-2316
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019866A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist