Organization
AV PHARMA LLC
Active
Organization
AV PHARMA LLC
Active
Other names
Citizen Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VIPUL B MAMTORA (DIRECTOR)
(844) 224-8493
Entity
Organization
Contact information
Practice address
1545 UNIVERSITY BLVD N, JACKSONVILLE, FL 32211-5229
(904) 619-3776
(844) 324-8493
Mailing address
PO BOX 600047, JACKSONVILLE, FL 32260-0047
(904) 619-3776
(844) 324-8493
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117117700
—
FL
Enumeration date
01/10/2022
Last updated
08/04/2026
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