Provider Demographics
NPI:1457812729
Name:IVIA HEALTH LLC
Entity Type:Organization
Organization Name:IVIA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMER
Authorized Official - Middle Name:
Authorized Official - Last Name:UGUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-777-2654
Mailing Address - Street 1:828 N OLDEN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-4902
Mailing Address - Country:US
Mailing Address - Phone:609-989-0134
Mailing Address - Fax:
Practice Address - Street 1:828 N OLDEN AVE STE 3
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-4902
Practice Address - Country:US
Practice Address - Phone:609-989-0134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy