Provider Demographics
NPI:1093569048
Name:SANO VITA INC
Entity Type:Organization
Organization Name:SANO VITA INC
Other - Org Name:RIVERGATE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE/RPH
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-375-7711
Mailing Address - Street 1:760 CHERRY GULCH RD
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6471
Mailing Address - Country:US
Mailing Address - Phone:970-749-3291
Mailing Address - Fax:
Practice Address - Street 1:575 RIVERGATE LN UNIT 111
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7490
Practice Address - Country:US
Practice Address - Phone:970-375-7711
Practice Address - Fax:970-375-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy