Live Oaks Octagon

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LIVE OAKS OCTAGON

Practice address

13521 Steelecroft Pkwy
Charlotte, NC 28278-7551

Phone

(646) 729-7578

Fax

(980) 256-4715

NPI assigned

May 19, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tom Mullen

Title

Manager

Phone

(646) 729-7578

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Live Oaks Octagon, LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1154778199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13521 STEELECROFT PKWY",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787551",
            "telephone_number": "646-729-7578",
            "fax_number": "980-256-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13521 STEELECROFT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787551",
            "telephone_number": "646-729-7578",
            "fax_number": "980-256-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAKS OCTAGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "646-729-7578"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160273",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Oaks Octagon, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele Liu, DDS
• Zhengyang Liu
• Mark C Livak, LCMHCA
• Chad A. Livasy, MD
• Live Long Well Care Enterprises LLC
• Live2Love Transportation
• Jonathan Byron Lively, PA
• Livewell Inc
• Livewell Inc
• Livewell Medical Inc

• Pharmacy in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.