Provider Demographics
NPI:1881915031
Name:ALIVIA INFUSION SERVICES LLC
Entity type:Organization
Organization Name:ALIVIA INFUSION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SABNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-920-6000
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0246
Mailing Address - Country:US
Mailing Address - Phone:787-620-9600
Mailing Address - Fax:787-779-3741
Practice Address - Street 1:107 EL TUQUE INDUSTRIAL PARK
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-2803
Practice Address - Country:US
Practice Address - Phone:787-651-8070
Practice Address - Fax:787-651-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336C0004X, 3336H0001X, 3336M0002X
PR18-F-33553336S0011X
PR16-F-28153336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2125388OtherPK