Provider Demographics
NPI:1033780937
Name:AMC PHARMACY LLC
Entity Type:Organization
Organization Name:AMC PHARMACY LLC
Other - Org Name:VIVENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-223-6874
Mailing Address - Street 1:1311 N 6TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-4006
Mailing Address - Country:US
Mailing Address - Phone:800-359-9272
Mailing Address - Fax:833-368-1247
Practice Address - Street 1:4309 E 50TH TER STE 200A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-2853
Practice Address - Country:US
Practice Address - Phone:866-454-8029
Practice Address - Fax:833-753-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy