Organization
ELLIOTT PHARMACY INC
Active
Organization
ELLIOTT PHARMACY INC
Active
Other names
Elliott Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY NELSON (OWNER)
(660) 665-9871
Entity
Organization
Contact information
Practice address
2120A NORTH BALTIMORE, KIRKSVILLE, MO 63501
(660) 665-9871
(660) 665-4332
Mailing address
PO BOX 729, KIRKSVILLE, MO 63501-0729
(660) 665-9871
(660) 665-9871
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
2008018246
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467609636
—
MO
01
—
2638166
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/19/2008
Last updated
11/18/2011
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