Provider Demographics
NPI:1760084834
Name:LIVINGSTON, JAMES ADDISON II
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ADDISON
Last Name:LIVINGSTON
Suffix:II
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 1:1520A TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2919
Mailing Address - Country:US
Mailing Address - Phone:803-256-3440
Mailing Address - Fax:803-638-6975
Practice Address - Street 1:1520A TAYLOR ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2919
Practice Address - Country:US
Practice Address - Phone:803-256-3440
Practice Address - Fax:803-638-6975
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist