Provider Demographics
NPI:1306182548
Name:ALIVIA SPECIALTY, LLC
Entity Type:Organization
Organization Name:ALIVIA SPECIALTY, LLC
Other - Org Name:ALIVIA SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARI
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:SABNANI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-920-6000
Mailing Address - Street 1:P.O. BOX 246
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960
Mailing Address - Country:US
Mailing Address - Phone:787-620-9600
Mailing Address - Fax:787-740-3666
Practice Address - Street 1:AMELIA INDUSTRIAL PARK, CALLE DIANA LOTE 18, PISO 2
Practice Address - Street 2:PUEBLO VIEJO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00934-0093
Practice Address - Country:US
Practice Address - Phone:787-925-1989
Practice Address - Fax:787-925-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2021-06-11
Deactivation Date:2015-05-13
Deactivation Code:
Reactivation Date:2016-12-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy