Organization
RAV PHARMA LLC
Active
Other names
HOMETOWN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASHISH KAPOOR (OFFICER)
(904) 515-0929
Entity
Organization
Contact information
Practice address
450077 STATE ROAD 200 STE 4, CALLAHAN, FL 32011-3863
(904) 515-0929
(844) 324-8493
Mailing address
PO BOX 600786, JACKSONVILLE, FL 32260-0786
(904) 515-0929
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31314
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177464
PK
—
Enumeration date
05/03/2018
Last updated
06/22/2023
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