Clifton G. Elliott, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4742IR Issued in LA

Legal business name

CLIFTON G. ELLIOTT, LLC

Practice address

77395 Landry Dr
Maringouin, LA 70757-3208

Phone

(225) 625-2353

Fax

(225) 625-3144

NPI assigned

Apr 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clifton Elliott

Title

Owner

Phone

(225) 625-2353

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 2

• ELLIOTT PHARMACY Doing business as
• Elliott Pharmacy 1 Doing business as

Tax ID family

Clifton G Elliott LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Clifton G. Elliott, LLC

  • Community/Retail Pharmacy
  • Saint Francisville, LA
  • NPI 1346628823
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1003033101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "MARINGOUIN",
            "state": "LA",
            "postal_code": "707570086",
            "telephone_number": "225-625-2353",
            "fax_number": "225-625-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77395 LANDRY DR",
            "city": "MARINGOUIN",
            "state": "LA",
            "postal_code": "707573208",
            "telephone_number": "225-625-2353",
            "fax_number": "225-625-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON G. ELLIOTT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-625-2353"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "4742IR",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1270806",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2028923",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLIOTT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ELLIOTT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elliott Pharmacy 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenosha Baise
• Kimberly Bessix, D.D.S.
• Alicia Bourgeois
• Krystle Danelle Chase-Circello, PA
• Chantelle Laura Corrent Johnson, FNP-C
• Marina Brynn Doucet, PA
• Charlotte Marie Goudeau, LM, CPM
• Innis Community Health Center, Inc
• Innis Community Health Center, Inc

• Community/Retail Pharmacy in Maringouin, LA
• Providers in Maringouin, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.