Provider Demographics
NPI:1932497013
Name:ARRIVA MEDICAL, LLC
Entity Type:Organization
Organization Name:ARRIVA MEDICAL, LLC
Other - Org Name:DBA ARRIVA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
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
Mailing Address - Country:US
Mailing Address - Phone:800-700-4442
Mailing Address - Fax:615-815-3130
Practice Address - Street 1:4252 NW 120TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:800-700-4442
Practice Address - Fax:877-223-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH256073336C0003X
FLPH2.72393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5706760OtherNCPDP