Provider Demographics
NPI:1376131524
Name:VIVE RX, INC.
Entity Type:Organization
Organization Name:VIVE RX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHPOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-415-2888
Mailing Address - Street 1:11207 S LA CIENEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-6112
Mailing Address - Country:US
Mailing Address - Phone:310-670-6337
Mailing Address - Fax:877-513-0770
Practice Address - Street 1:11207 S LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6112
Practice Address - Country:US
Practice Address - Phone:310-670-6337
Practice Address - Fax:877-513-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy