NPI age
11 years
Enumerated 2015-04-23
● Active
Type 1 · Individual
MR. Mark Aldor Ellingson, R.PH.
Ellingson is 1 of 1 pharmacist providers in Osburn and 1 of 1739 in Idaho.
Primary specialty
Pharmacist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-04-23
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1739 active pharmacist providers in Idaho.
NPI age
11 years
≈ at median (10 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-04Enumerated in NPPES
2015
2026
Where they practice
Practice location
805 Mullan Avenue, Box 2170
Osburn, ID 83849
Mailing address
805 Mullan Avenue
Osburn, ID 83849
Specialties
-
Pharmacist PrimaryAn individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002450000 |
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.