OrganizationActive
Av Pharma LLC
NPI 1629589908 · Compounding Pharmacy · Jacksonville, FL
Provider details
- NPI number
- 1629589908
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Vipul Mamtora, Member Manager(904) 440-0611
Specialties & taxonomies
Suppliers
Practice location
1545 University Blvd N Ste C
Jacksonville, FL 32211-5229
Phone: (904) 440-0611
Fax: (904) 323-4083
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 600047
Jacksonville, FL 32260-0047
Other names (DBA / former)
- Doing business as
- Citizen Pharmacy # 712
Registry dates
- Enumerated
- 2017-10-13
- Last updated
- 2025-12-15
- Certified
- 2025-12-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.