Organization
VIVENT PHARMACY LLC
Active
Other names
Vivent Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY FIELDS (CHIEF PHARMACY OFFICER)
(414) 223-6874
Entity
Organization
Contact information
Practice address
1311 N 6TH ST STE 102, MILWAUKEE, WI 53212-4006
(414) 223-6820
Mailing address
1311 N 6TH ST STE 201, MILWAUKEE, WI 53212-4006
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
07/25/2024
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