Provider Demographics
NPI:1205119823
Name:LIVINGSTON, SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 GREEN GABLES CIR
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-8646
Mailing Address - Country:US
Mailing Address - Phone:303-902-7933
Mailing Address - Fax:
Practice Address - Street 1:15310 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-5806
Practice Address - Country:US
Practice Address - Phone:720-262-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist