Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellisville State School

Organization Pharmacy · NPI 1578668901

Ellisville State School is a Pharmacy in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
Specialties on file
2

Practice location Address checks out

1101 Highway 11 S
Ellisville, MS 39437-4443
Phone: (601) 477-5785
Fax: (601) 477-5687
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Long Term Care Pharmacy (primary) Taxonomy 3336L0003X · Licence 01185031 (MS)
Pharmacy Taxonomy 333600000X

Record details

NPI number1578668901
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patti Welch — Phcy Dir · (601) 477-5784
Other names Ellisville State School Pharmacy; Ellisville State School Pharmacy
NPI enumeratedSeptember 13, 2006
Last updated in NPPESDecember 17, 2019
Certification dateDecember 17, 2019
Mailing address1101 Highway 11 S, Ellisville, MS 39437-4443

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