Active NPI
Vivent Pharmacy LLC
Doing business as AMC Pharmacy
- Pharmacy
- Milwaukee, WI
National Provider Identifier
1760784086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- VIVENT PHARMACY LLC
- Doing business as
- AMC Pharmacy
Vivent Pharmacy - Practice address
- 1311 N 6TH St Ste 101
Milwaukee, WI 53212-4006 - Phone
- (888) 393-0351
- Fax
- (833) 368-1247
- NPI assigned
- Nov 18, 2010
- 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, PHARMD
- Title
- Chief Pharmacy Officer
- Phone
- (414) 223-6874
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X | 9049-42 | WI |
Addresses
Primary practice location
1311 N 6TH St Ste 101
Milwaukee, WI 53212-4006
Mailing address
1311 N 6TH St Ste 201
Milwaukee, WI 53212-4006
Other practice location 1
820 N Plankinton Ave
Milwaukee, WI 53203-1802
Phone (414) 223-6820
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2128078 | Other | PK | |
| 100013165 | Medicaid | WI |
Other names 2
- AMC Pharmacy
- Vivent Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240827000943 | WI | Part B Supplier - Pharmacy | 7810436557 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Milwaukee, WI; Madison, WI |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba AMC Pharmacy
- Community/Retail Pharmacy
- Madison, WI
- NPI 1801279583
O20240827000943
National Provider Directory
National Provider Directory- Tax ID family
- AMC Pharmacy
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1311 N 6th St
Ste 101
Milwaukee, WI 53212
Phone (888) 393-0351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290038400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714608000000",
"number": "1760784086",
"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",
"fax_number": "833-368-1247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 N 6TH ST STE 101",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532124006",
"telephone_number": "888-393-0351",
"fax_number": "833-368-1247"
}
],
"practiceLocations": [
{
"address_1": "820 N Plankinton Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532031802",
"country_code": "US",
"telephone_number": "414-223-6820",
"fax_number": "414-223-6821",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "VIVENT PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-18",
"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",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WI",
"license": "9049-42",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2128078",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100013165",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "AMC Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Vivent Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Milwaukee, WI
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.