Organization
ELLIOTT PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY P. NELSON R.PH (OWNER)
(660) 665-9871
Entity
Organization
Contact information
Practice address
2120 N BALTIMORE ST, KIRKSVILLE, MO 63501-5109
(660) 665-9871
(660) 665-4332
Mailing address
PO BOX 72, KIRKSVILLE, MO 63501-0072
(660) 665-9871
(660) 665-4332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
620398800
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600398804
—
MO
Enumeration date
01/31/2007
Last updated
09/18/2008
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