Provider Demographics
NPI:1942585625
Name:VIVI PHARMACY LLC
Entity Type:Organization
Organization Name:VIVI PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-456-5236
Mailing Address - Street 1:1250 NW 7 ST
Mailing Address - Street 2:SUITE 101-102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-456-5236
Mailing Address - Fax:305-456-6347
Practice Address - Street 1:1250 NW 7 ST
Practice Address - Street 2:SUITE 101-102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-456-5236
Practice Address - Fax:305-456-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy