1073175675 NPI number — LIVINGSTON COMMUNITY HEALTH

Table of content: MRS. TERESA K BARSOTTI CRNA (NPI 1841241478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073175675 NPI number — LIVINGSTON COMMUNITY HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON COMMUNITY HEALTH
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:
LCH PHARMACY
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:
1073175675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 S POLK ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79101-1436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-242-7782
Provider Business Mailing Address Fax Number:
209-214-6103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 B ST BLDG B ROOM 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95334-9593
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-789-5321
Provider Business Practice Location Address Fax Number:
209-214-6103
Provider Enumeration Date:
07/03/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT OF PHARMACY SERVICES
Authorized Official Telephone Number:
806-242-7782

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1073175675 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".