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Organization
VIVA PHARMACY & WELLNESS
Active
Organization
VIVA PHARMACY & WELLNESS
Active
Other names
Viva Pharmacy & Wellness, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
LATCHMIN RAGHUNAUTH DOCTOR OF PHARM (PIC, AO)
(718) 450-9696
Entity
Organization
Contact information
Practice address
8014 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1345
(718) 450-9595
(718) 450-9797
Mailing address
8014 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1345
(718) 450-9595
(718) 450-9797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
033886
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04415101
—
NY
01
—
2154031
PK
—
Enumeration date
09/01/2015
Last updated
10/31/2024
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