Organization
PAVILION INFUSION THERAPY INC
Active
Parent organization
PAVILION INFUSION THERAPY INC
Other names
Baptist Infusion Therapy Bonneval
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAVILION INFUSION THERAPY INC
Authorized official
CHRISTOPHER ROBERT DURKIN FHFMA (VP)
(904) 202-5887
Entity
Organization
Contact information
Practice address
6930 BONNEVAL RD, SUITE 3, JACKSONVILLE, FL 32216
(904) 202-5760
(904) 281-0217
Mailing address
1660 PRUDENTIAL DR STE 203, JACKSONVILLE, FL 32207-8185
(904) 202-5887
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1313883
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
1313883
FL
Other
Enumeration date
12/13/2012
Last updated
06/26/2018
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