Provider Demographics
NPI:1588216279
Name:ELMES, ANTHONY M (RPH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:ELMES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 YOCKEY ESTS
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:IN
Mailing Address - Zip Code:47446-6925
Mailing Address - Country:US
Mailing Address - Phone:812-277-9705
Mailing Address - Fax:401-652-1140
Practice Address - Street 1:307 E NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2629
Practice Address - Country:US
Practice Address - Phone:812-446-7108
Practice Address - Fax:812-446-0012
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015713A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist