Provider Demographics
NPI:1861908972
Name:VIVA CORP.
Entity type:Organization
Organization Name:VIVA CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:787-318-6966
Mailing Address - Street 1:1034 CALLE CERRO SALIENTE
Mailing Address - Street 2:QUINTAS DE ALTAMIRA
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-318-6966
Mailing Address - Fax:787-987-8483
Practice Address - Street 1:CARR 14 KM 18.3
Practice Address - Street 2:SECTOR TIJERAS
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-987-8482
Practice Address - Fax:787-987-8483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIVA CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 3336L0003X
PR19-F-35283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy