Provider Demographics
NPI:1518471010
Name:ANIVA MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:ANIVA MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-315-5037
Mailing Address - Street 1:321 NORTHLAKE BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5411
Mailing Address - Country:US
Mailing Address - Phone:561-612-7031
Mailing Address - Fax:561-658-0331
Practice Address - Street 1:321 NORTHLAKE BLVD STE 216
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5411
Practice Address - Country:US
Practice Address - Phone:561-612-7031
Practice Address - Fax:561-658-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies