OrganizationActive
Ellisville State School
NPI 1578668901 · Long Term Care Pharmacy · Ellisville, MS
Provider details
- NPI number
- 1578668901
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Patti Welch, Phcy Dir(601) 477-5784
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1101 Highway 11 S
Ellisville, MS 39437-4443
Phone: (601) 477-5785
Fax: (601) 477-5687
Approximate (ZIP-level) locationGet directions
Mailing address
1101 Highway 11 S
Ellisville, MS 39437-4443
Other names (DBA / former)
- Doing business as
- Ellisville State School Pharmacy
- Doing business as
- Ellisville State School Pharmacy
Registry dates
- Enumerated
- 2006-09-13
- Last updated
- 2019-12-17
- Certified
- 2019-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.