Organization
CLIFTON G. ELLIOTT, LLC
Active
Other names
Elliott Pharmacy 1, ELLIOTT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON ELLIOTT (OWNER)
(225) 625-2353
Entity
Organization
Contact information
Practice address
77395 LANDRY DR, MARINGOUIN, LA 70757-3208
(225) 625-2353
(225) 625-3144
Mailing address
PO BOX 86, MARINGOUIN, LA 70757-0086
(225) 625-2353
(225) 625-3144
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4742IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1270806
—
LA
01
—
2028923
PK
—
Enumeration date
04/19/2007
Last updated
08/15/2023
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