| Viva Advanced Healthcare Inc | |
|
1107 W Oklahoma Ave Milwaukee WI 53215-4617 | |
| (414) 551-2911 | |
| (414) 384-3404 |
| Full Name | Viva Advanced Healthcare Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1107 W Oklahoma Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Manuel D Thomas (PRESIDENT/OWNER) |
| Authorized Official Contact | 4145512911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Viva Advanced Healthcare Inc Po Box 639 Thiensville WI 53092-0639 Ph: (414) 247-9005 | Viva Advanced Healthcare Inc 1107 W Oklahoma Ave Milwaukee WI 53215-4617 Ph: (414) 551-2911 |
| NPI Number | 1841643897 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 07/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841643897 | NPI | - | NPPES |
| 1790870558 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 47171 (Wisconsin) | Primary |
| 208000000X | Pediatrics | 47171 (Wisconsin) | Secondary |
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