Healthcare Provider Details

I. General information

NPI: 1205119823
Provider Name (Legal Business Name): SCOTT LIVINGSTON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15310 E COLFAX AVE
AURORA CO
80011-5806
US

IV. Provider business mailing address

1080 GREEN GABLES CIR
BENNETT CO
80102-8646
US

V. Phone/Fax

Practice location:
  • Phone: 720-262-4615
  • Fax:
Mailing address:
  • Phone: 303-902-7933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12236
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: