Provider Demographics
NPI:1124353297
Name:VIVA PHARMACY INC
Entity type:Organization
Organization Name:VIVA PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENGIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CELIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-939-1490
Mailing Address - Street 1:171 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-3832
Mailing Address - Country:US
Mailing Address - Phone:215-425-9520
Mailing Address - Fax:215-425-9522
Practice Address - Street 1:171 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3832
Practice Address - Country:US
Practice Address - Phone:215-425-9520
Practice Address - Fax:215-425-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
PAPP481964333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122793OtherPK