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NPI Code Detail

MEDICARE: LIV SPECIALTY CARE CT PC

MEDICARE: LIV SPECIALTY CARE CT PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2208VP0000XPain Medicine Physician
3261QI0500XInfusion Therapy Clinic/Center

General Provider Information

NPI Number : 1275314148
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIV SPECIALTY CARE CT PC
Provider Business Mailing Address
First Line : PO BOX 53304
Second Line :
City : PHOENIX
State : AZ
Zip : 85072-3304
Country : US
Telephone Number : 844-614-2354
Fax Number : 844-278-8635
Provider Business Practice Location Address
First Line : 47010 COMMUNITY PLZ STE 150
Second Line :
City : STERLING
State : VA
Zip : 20164-1896
Country : US
Telephone Number : 703-977-6779
Fax Number : 703-202-5685
Authorized Official
Title or Position : SENIOR REIMBURSEMENT MANAGER
Name : CHARLES MICHAEL BUCY
Credential :
Telephone Number : 844-614-2354
Provider Enumeration Date : 10/09/2023
Last Update Date : 05/18/2026

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Directions to “LIV SPECIALTY CARE CT PC ” Practice Location

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