Provider Demographics
NPI:1538147202
Name:LIVINGSTON INFUSION CARE
Entity type:Organization
Organization Name:LIVINGSTON INFUSION CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-226-7450
Mailing Address - Street 1:603 MONTROSE AVE
Mailing Address - Street 2:LIVINGSTON INFUSION CARE
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2601
Mailing Address - Country:US
Mailing Address - Phone:908-226-7450
Mailing Address - Fax:908-822-9723
Practice Address - Street 1:603 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2601
Practice Address - Country:US
Practice Address - Phone:908-226-7450
Practice Address - Fax:908-822-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 333600000X
NJ251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00577400OtherSTATE OF NEW JERSEY
NJ8070504Medicaid
NJ0696170001Medicare NSC