Provider Demographics
NPI:1588787444
Name:ELLIOTT, DARIN LAMAR (PHARMD)
Entity type:Individual
Prefix:
First Name:DARIN
Middle Name:LAMAR
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8642 ROCKBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-8808
Mailing Address - Country:US
Mailing Address - Phone:334-294-2900
Mailing Address - Fax:334-286-9431
Practice Address - Street 1:4724 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36108-5127
Practice Address - Country:US
Practice Address - Phone:334-286-8182
Practice Address - Fax:334-286-9431
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist