# CLIFTON G. ELLIOTT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elliott Pharmacy 1, ELLIOTT PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003033101
- **Authorized official:** CLIFTON ELLIOTT (OWNER)
- **Authorized official phone:** (225) 625-2353

## Contact information

- **Practice address:** 77395 LANDRY DR, MARINGOUIN, LA 70757-3208
- **Practice address phone:** (225) 625-2353
- **Practice address fax:** (225) 625-3144
- **Mailing address:** PO BOX 86, MARINGOUIN, LA 70757-0086
- **Mailing address phone:** (225) 625-2353
- **Mailing address fax:** (225) 625-3144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 4742IR | LA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 08/15/2023