Organization
GEORGE ELLIOTT INC
Active
Other names
ELLIOTT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON ELLIOTT PHRM (OWNER)
(225) 642-9000
Entity
Organization
Contact information
Practice address
6150 HWY 74, ST GABRIEL, LA 70776
(225) 642-9000
(225) 642-9002
Mailing address
PO BOX 74, SAINT GABRIEL, LA 70776-0074
(225) 642-9000
(225) 642-9022
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY004743IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1270849
—
LA
01
—
1927396
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2007
Last updated
08/29/2011
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