Provider Demographics
NPI:1427608462
Name:LIVINGSTON PHARMACY LLC
Entity type:Organization
Organization Name:LIVINGSTON PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-703-3492
Mailing Address - Street 1:503 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-2839
Mailing Address - Country:US
Mailing Address - Phone:936-327-0213
Mailing Address - Fax:
Practice Address - Street 1:503 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-2839
Practice Address - Country:US
Practice Address - Phone:936-327-0213
Practice Address - Fax:936-327-1053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVINGSTON PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-11
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy