Provider Demographics
NPI:1073206421
Name:VIVA DME LC
Entity Type:Organization
Organization Name:VIVA DME LC
Other - Org Name:GOGO ACCESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:OPPONG
Authorized Official - Middle Name:
Authorized Official - Last Name:GYAMFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-684-8411
Mailing Address - Street 1:14280 BALTIMORE AVE # 1001
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5006
Mailing Address - Country:US
Mailing Address - Phone:301-684-8411
Mailing Address - Fax:
Practice Address - Street 1:5534 TUXEDO RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1318
Practice Address - Country:US
Practice Address - Phone:301-684-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty