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General NPI Number Information
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NPI Number | 1518834167
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Entity Type | Organization
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Legal Business Name | CLOVIS AI LLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2441 BELLEVUE AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-5615
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Country | US
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Telephone | 772-475-2277
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Fax | 888-877-3919
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-0548
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Country | US
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Telephone | 321-626-6164
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Fax | 888-877-3919
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Authorized Official
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Title or Position | CFO
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Name | GARRETT SOWARDS
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Credential |
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Telephone | 321-626-6164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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