Organization
VIVA IV THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME JEREMY CORDOVA MD (OWNER)
(505) 480-1733
Entity
Organization
Contact information
Practice address
7320 E 6TH AVE, SCOTTSDALE, AZ 85251-3402
(480) 508-8482
Mailing address
7320 E 6TH AVE, SCOTTSDALE, AZ 85251-3402
(480) 508-8482
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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