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General NPI Number Information
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NPI Number | 1508161910
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Entity Type | Organization
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Legal Business Name | LIVERNOIS RX, INC.
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1105 CENTRAL EXPWY N SUITE 2110
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City | ALLEN
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State | TX
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Zip | 75013
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Country | US
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Telephone | 844-370-8581
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Fax | 469-675-3427
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Provider Business Mailing Address
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Address Line | 1105 CENTRAL EXPWY N. SUITE 2110
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City | ALLEN
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State | TX
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Zip | 75013
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Country | US
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Telephone | 469-656-7987
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Fax | 469-421-2150
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT G HAYWOOD
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Credential |
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Telephone | 972-930-5254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 27324
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 27324
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License Number State | TX
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