Provider Demographics
NPI:1699400051
Name:VIVINO GROUP INC
Entity Type:Organization
Organization Name:VIVINO GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VIVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-548-0400
Mailing Address - Street 1:2846 LINKHORNE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-3322
Mailing Address - Country:US
Mailing Address - Phone:434-548-0400
Mailing Address - Fax:956-433-5763
Practice Address - Street 1:2846 LINKHORNE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-3322
Practice Address - Country:US
Practice Address - Phone:434-548-0400
Practice Address - Fax:956-433-5763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care