Provider Demographics
NPI:1134132020
Name:MIV CARE INC
Entity Type:Organization
Organization Name:MIV CARE INC
Other - Org Name:RX CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-370-7483
Mailing Address - Street 1:19000 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-370-7483
Mailing Address - Fax:310-370-7726
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-370-7483
Practice Address - Fax:310-370-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY461383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0578457OtherNABP
CAPHA461380Medicaid
0578457OtherNABP