1538147202 NPI number — LIVINGSTON INFUSION CARE

Table of content: (NPI 1538147202)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538147202 NPI number — LIVINGSTON INFUSION CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON INFUSION CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QUALITAS PHARMACY SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538147202
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
603 MONTROSE AVE
Provider Second Line Business Mailing Address:
LIVINGSTON INFUSION CARE
Provider Business Mailing Address City Name:
SOUTH PLAINFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07080-2601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-226-7450
Provider Business Mailing Address Fax Number:
908-822-9723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
603 MONTROSE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07080-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-226-7450
Provider Business Practice Location Address Fax Number:
908-822-9723
Provider Enumeration Date:
01/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SESTA
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
V.P. RP IN CHARGE
Authorized Official Telephone Number:
908-226-7450

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3141710 . This is a "NABP#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8070504 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com