NPIMap

Organization Active NPI

Vivawell Pharmacy Company

Doing business as VivaRx LTC

  • Long Term Care Pharmacy
  • Rancho Mirage, CA
National Provider Identifier
1477299527
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
VIVAWELL PHARMACY COMPANY
Doing business as
VivaRx LTC
Practice address
72780 Country Club Dr Ste 403
Rancho Mirage, CA 92270-4149
Phone
(760) 610-6512
Fax
(760) 610-6981
NPI assigned
May 11, 2022
Last updated
Jun 4, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
VIVAWELL PHARMACY COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Authorized official

Name
Jason B KiroyanNPI 1396210290
Title
Ceo
Phone
(760) 610-6512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

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

Mailing address

72780 Country Club Dr Ste 403
Rancho Mirage, CA 92270-4149
Phone (760) 610-6512

Other identifiers 1

IdentifierTypeStateIssuer
1396107249MedicaidCA

Other names 1

  • VivaRx LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Health Care Pioneers2 organizations share this tax ID, including this one
Part of
Health Care Pioneers

Other organizations with this tax ID 1

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

Locations

72780 Country Club Dr
Ste 403
Rancho Mirage, CA 92270
Phone (760) 610-6512

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1477299527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR 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 STE 403",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704149",
            "telephone_number": "760-610-6512",
            "fax_number": "760-610-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVAWELL PHARMACY COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIVAWELL PHARMACY COMPANY",
        "enumeration_date": "2022-05-11",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "KIROYAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-610-6512"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396107249",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VivaRx LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.