Active NPI
AMC Pharmacy LLC
Doing business as Vivent Pharmacy
- Community/Retail Pharmacy
- Saint Louis, MO
National Provider Identifier
1174220404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- AMC PHARMACY LLC
- Doing business as
- Vivent Pharmacy
- Practice address
- 3915 Watson Rd Ste 200
Saint Louis, MO 63109-1251 - Phone
- (888) 504-2621
- NPI assigned
- Feb 7, 2023
- Last updated
- May 2, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony Fields
- Title
- Chief Pharmacy Officer
- Phone
- (414) 223-6874
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
3915 Watson Rd Ste 200
Saint Louis, MO 63109-1251
Mailing address
1311 N 6TH St Ste 201
Milwaukee, WI 53212-4006
Phone (800) 359-9272
Other names 1
- Vivent Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240926004423 | MO | Part B Supplier - Pharmacy | 3072044395 |
2 other NPIs on this enrollment Practice locations: Kansas City, MO; Saint Louis, MO |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Vivent Pharmacy
- Community/Retail Pharmacy
- Kansas City, MO
- NPI 1033780937
O20240926004423
-
dba AMC Pharmacy
- Community/Retail Pharmacy
- Saint Louis, MO
- NPI 1366926552
O20240926004423
National Provider Directory
National Provider Directory- Tax ID family
- AMC Pharmacy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714608000000",
"number": "1174220404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 N 6TH ST STE 201",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532124006",
"telephone_number": "800-359-9272",
"fax_number": "833-368-1247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 WATSON RD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631091251",
"telephone_number": "888-504-2621"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMC PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-02-07",
"last_updated": "2024-05-02",
"certification_date": "2024-05-02",
"status": "A",
"authorized_official_last_name": "FIELDS",
"authorized_official_first_name": "TONY",
"authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
"authorized_official_telephone_number": "414-223-6874"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Vivent Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Vivent Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.