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General NPI Number Information
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NPI Number | 1689925299
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Entity Type | Organization
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Legal Business Name | LIVEWELL INC
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 1706 S CANNON BLVD
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City | KANNAPOLIS
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State | NC
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Zip | 28083-6104
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Country | US
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Telephone | 704-933-6337
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Fax | 704-933-6374
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Provider Business Mailing Address
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Address Line | 1706 S CANNON BLVD
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City | KANNAPOLIS
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State | NC
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Zip | 28083-6104
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Country | US
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Telephone | 704-933-6337
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Fax | 704-933-6374
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. GEORGE WILLIAM VELTRI
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Credential | R.PH.
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Telephone | 704-933-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 08881
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License Number State | NC
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