Organization
AV PHARMA LLC
Active
Other names
CITIZEN PHARMACY # 712
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIPUL MAMTORA (MEMBER MANAGER)
(904) 440-0611
Entity
Organization
Contact information
Practice address
1545 UNIVERSITY BLVD N STE C, JACKSONVILLE, FL 32211-5229
(904) 440-0611
(904) 323-4083
Mailing address
PO BOX 600047, JACKSONVILLE, FL 32260-0047
(904) 440-0611
(904) 323-4083
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
10/13/2017
Last updated
12/15/2025
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