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General NPI Number Information
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NPI Number | 1316592538
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Entity Type | Organization
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Legal Business Name | AV PHARMA LLC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1545 UNIVERSITY BLVD N STE B
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5229
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Country | US
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Telephone | 877-811-1129
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Fax | 855-811-3423
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Provider Business Mailing Address
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Address Line | PO BOX 600047
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City | JACKSONVILLE
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State | FL
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Zip | 32260-0047
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Country | US
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Telephone | 877-811-1129
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Fax | 855-811-3423
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Authorized Official
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Title or Position | DIRECTOR
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Name | VIPUL MAMTORA
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Credential |
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Telephone | 877-811-1129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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