Organization
ROBERT E LIVINGSTON III MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E LIVINGSTON III MD (OWNER)
(803) 276-0004
Entity
Organization
Contact information
Practice address
2624 MAIN ST, NEWBERRY, SC 29108-4002
(803) 276-0004
(803) 276-0006
Mailing address
2624 MAIN ST, PO BOX 130, NEWBERRY, SC 29108-4002
(803) 276-0004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5609260001
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050830
—
SC
01
—
5609260001
DMERC SUPPLIER
SC
01
—
DE9043
RAILROAD MEDICARE
SC
Enumeration date
12/14/2007
Last updated
06/06/2013
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