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General NPI Number Information
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NPI Number | 1831953579
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Entity Type | Organization
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Legal Business Name | VIVMEDS PHARMACY CORPORATION
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 3303 UNICORN LAKE BLVD STE 280
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City | DENTON
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State | TX
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Zip | 76210-0169
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Country | US
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Telephone | 940-226-4849
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Fax | 940-226-4859
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Provider Business Mailing Address
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Address Line | 3303 UNICORN LAKE BLVD STE 280
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City | DENTON
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State | TX
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Zip | 76210-0169
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Country | US
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Telephone | 940-226-4849
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | DR. MARIA TEMILOLA DOMINIC
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Credential |
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Telephone | 940-226-4849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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