Provider Demographics
NPI:1902829468
Name:LIVINGOOD, ANGELA SMITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:SMITH
Last Name:LIVINGOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:WILSON
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:423 YOPP RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3594
Mailing Address - Country:US
Mailing Address - Phone:910-347-9684
Mailing Address - Fax:910-455-0622
Practice Address - Street 1:423 YOPP RD
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3594
Practice Address - Country:US
Practice Address - Phone:910-347-9684
Practice Address - Fax:910-455-0622
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist