Vivawell Pharmacy Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54279 Issued in CA

Legal business name

VIVAWELL PHARMACY COMPANY

Practice address

72780 Country Club Dr
Ste 403
Rancho Mirage, CA 92270-4149

Phone

(760) 610-6512

NPI assigned

Mar 21, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason KiroyanNPI 1396210290

Title

Ceo/Cfo/Sec/Dir

Phone

(909) 647-7354

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 2

• VivaRx Doing business as
• VivaRx Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

Health Care Pioneers2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vivawell Pharmacy Company

  • Long Term Care Pharmacy
  • Rancho Mirage, CA
  • NPI 1477299527
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Vivawell Pharmacy Company

  • Long Term Care Pharmacy
  • Rancho Mirage, CA
  • NPI 1477299527
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Kiroyan, PHARMD

  • Pharmacist
  • Rancho Mirage, CA
  • NPI 1396210290
  NPD Authorized official
• Iliana Marie Liwanag, PHARMD

  • Pharmacist
  • Rancho Mirage, CA
  • NPI 1679208912
  NPD
• Rushabh C Bhakta, M. PHARM

  • Pharmacist
  • Rancho Mirage, CA
  • NPI 1841451820
  NPD (past)
• Shailaja Karanti, PHARM D

  • Pharmacist
  • Rancho Mirage, CA
  • NPI 1811343304
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1396107249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "STE 403",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704149",
            "telephone_number": "760-610-6512",
            "fax_number": "760-610-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "STE 403",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704149",
            "telephone_number": "760-610-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVAWELL PHARMACY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "KIROYAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO/CFO/SEC/DIR",
        "authorized_official_telephone_number": "909-647-7354"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54279",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396107249",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158852",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VivaRx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VivaRx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sangeetha Vinayagam, MD
• Claire Vines, PSY D LMFT TF-CBT
• Arman Sarkis Virabov, MD
• Julie J Virgin, PHD, CNS, CHFI
• Vista Cove at Rancho Mirage
• Vivawell Pharmacy Company
• Arna Susan Vodenos
• Kay L. Vogt, PSY.D.
• Michael E. Voskanian, P.A.-C.
• Kia Vosoughi

• Community/Retail Pharmacy in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.

Verify at the official NPI Registry.