Organization
PAVILION INFUSION THERAPY INC
Active
Other names
Baptist Infusion Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DURKIN FHFMA (VP)
(904) 202-5887
Entity
Organization
Contact information
Practice address
3563 PHILIPS HWY, STE 202, JACKSONVILLE, FL 32207-5663
(904) 202-5730
(904) 398-2225
Mailing address
3563 PHILIPS HWY, STE 202, JACKSONVILLE, FL 32207-5663
(904) 202-5730
(904) 398-2225
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PH13801
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102335700
—
FL
01
—
2011769
PK
—
Enumeration date
08/10/2006
Last updated
03/16/2017
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