Vivent Pharmacy Michigan LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VIVENT PHARMACY MICHIGAN LLC

Doing business as

Vivent Pharmacy

Practice address

64 Victor St Ste 101
Highland Park, MI 48203-3128

Phone

(888) 810-1434

Fax

(313) 447-2239

NPI assigned

Feb 7, 2025

Last updated

Nov 10, 2025By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Vivent Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vivent Health Inc

  • Clinic/Center
  • Milwaukee, WI
  • NPI 1982654091

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1730994864",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 VICTOR ST STE 101",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033128",
            "telephone_number": "888-810-1434",
            "fax_number": "313-447-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVENT PHARMACY MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivent Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meghan Alexandra Valade
• Clarice Valdry, RN
• Stephanie Vieira
• Jeanett Villagomezde Muir, MSW
• Visions House
• Wally S. Mahar, M.D. P.L.L.C.
• Keith Walton, FAODP
• Aliya Deshaun Washington
• David Watkins
• Catrina Weaver

• Community/Retail Pharmacy in Highland Park, MI
• Providers in Highland Park, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.