Healthcare Provider Details

I. General information

NPI: 1164337341
Provider Name (Legal Business Name): ERYKA ELLINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TAYLOR RD
MONTGOMERY AL
36117-3512
US

IV. Provider business mailing address

7419 OLD PUMP RD
MONTGOMERY AL
36117-3971
US

V. Phone/Fax

Practice location:
  • Phone: 334-277-3330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23991
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: