Organization
LIVERNOIS RX, INC.
Active
Other names
Livernois Rx, ImprimisRx
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT G HAYWOOD (PRESIDENT)
(972) 930-5254
Entity
Organization
Contact information
Practice address
1105 CENTRAL EXPWY N, SUITE 2110, ALLEN, TX 75013
(844) 370-8581
(469) 675-3427
Mailing address
1105 CENTRAL EXPWY N., SUITE 2110, ALLEN, TX 75013
(469) 656-7987
(469) 421-2150
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
27324
TX
3336C0003X
Community/Retail Pharmacy
Primary
27324
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27324
PHARMACY LICENSE
TX
01
—
5902285
NCPDP
—
Enumeration date
01/14/2011
Last updated
03/07/2023
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