Provider Demographics
NPI:1477158343
Name:ROSS, WILLIAM LIVINGSTON
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LIVINGSTON
Last Name:ROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHELLEY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2420
Mailing Address - Country:US
Mailing Address - Phone:724-594-6332
Mailing Address - Fax:
Practice Address - Street 1:590 W TRENTON AVE
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-3513
Practice Address - Country:US
Practice Address - Phone:215-736-9003
Practice Address - Fax:215-736-2678
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist