Organization
GEORGE ELLIOTT INC
Active
Other names
ELLIOT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ELLIOT RPH (OWNER/SECRETARY)
(225) 625-2353
Entity
Organization
Contact information
Practice address
169 E MAIN ST, NEW ROADS, LA 70760-3505
(225) 638-7186
(225) 638-7330
Mailing address
169 E MAIN ST, NEW ROADS, LA 70760-3505
(225) 638-7186
(225) 638-7330
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY005089IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1270814
—
LA
01
—
2035387
PK
—
Enumeration date
03/27/2007
Last updated
12/10/2014
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