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General NPI Number Information
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NPI Number | 1750659801
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Entity Type | Organization
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Legal Business Name | LIVINGSTON PRESCRIPTION PHARMACY INC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 1289 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43205-2838
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Country | US
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Telephone | 614-253-6693
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Fax | 614-253-5637
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Provider Business Mailing Address
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Address Line | 1289 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43205-2838
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Country | US
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Telephone | 614-253-6693
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Fax | 614-253-5637
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | REBECCA WILKE
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Credential |
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Telephone | 614-253-6693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RTP.022173900-03
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License Number State | OH
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