Provider Demographics
NPI:1285910190
Name:SAINE, MICHAELLE LIVINGSTON (RPH)
Entity type:Individual
Prefix:
First Name:MICHAELLE
Middle Name:LIVINGSTON
Last Name:SAINE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12479 PRESERVATION POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-6728
Mailing Address - Country:US
Mailing Address - Phone:704-519-6051
Mailing Address - Fax:
Practice Address - Street 1:12479 PRESERVATION POINTE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-6728
Practice Address - Country:US
Practice Address - Phone:704-519-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist