Provider Demographics
NPI:1265233837
Name:VIVA MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:VIVA MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-812-1383
Mailing Address - Street 1:701 W KIMBERLY AVE STE 266
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-6342
Mailing Address - Country:US
Mailing Address - Phone:951-801-2502
Mailing Address - Fax:
Practice Address - Street 1:701 W KIMBERLY AVE STE 266
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6342
Practice Address - Country:US
Practice Address - Phone:951-801-2502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies