Provider Demographics
NPI:1730501396
Name:ARRIVA MEDICAL, LLC
Entity Type:Organization
Organization Name:ARRIVA MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STOCKSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-864-2005
Mailing Address - Street 1:4252 NW 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7603
Mailing Address - Country:US
Mailing Address - Phone:800-700-4442
Mailing Address - Fax:954-400-5423
Practice Address - Street 1:500 EAGLES LANDING DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-2899
Practice Address - Country:US
Practice Address - Phone:866-336-4103
Practice Address - Fax:954-400-5423
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALERE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 27239333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy