Provider Demographics
NPI:1568507598
Name:CV HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CV HEALTH SERVICES, INC.
Other - Org Name:MEDICAL GROUP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VIVO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-787-4490
Mailing Address - Street 1:8215 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4810
Mailing Address - Country:US
Mailing Address - Phone:818-787-4490
Mailing Address - Fax:818-787-4494
Practice Address - Street 1:8215 VAN NUYS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4810
Practice Address - Country:US
Practice Address - Phone:818-787-4490
Practice Address - Fax:818-787-4494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY44275332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA442750Medicaid
1222100002Medicare ID - Type Unspecified