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General NPI Number Information
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NPI Number | 1619213212
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Entity Type | Organization
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Legal Business Name | ANOVORX GROUP LLC
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Dates
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Enumeration Date | 12/31/2012
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 1710 SHELBY OAKS DR N SUITE 1
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City | MEMPHIS
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State | TN
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Zip | 38134-7403
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Country | US
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Telephone | 901-201-5470
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Fax | 901-201-5465
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Provider Business Mailing Address
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Address Line | 1710 SHELBY OAKS DR N SUITE 2
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City | MEMPHIS
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State | TN
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Zip | 38134-7403
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Country | US
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Telephone | 901-201-5470
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/PRESIDENT
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Name | JON PETERS
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Credential |
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Telephone | 901-201-5484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | OSP.0006189
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PMP.833
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | Y005790
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | A9-0001296
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 64001473A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 054.018178
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 34084MS
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License Number State | ID
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Taxonomy #8
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PHNR000415
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 4155
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License Number State | IA
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Taxonomy #10
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | NRP1461
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License Number State | CA
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Taxonomy #11
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH27151
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License Number State | FL
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Taxonomy #12
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PCN.0002570
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License Number State | CT
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Taxonomy #13
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | NRX0000453
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License Number State | DC
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Taxonomy #14
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 22-13044
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License Number State | KS
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Taxonomy #15
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 1314
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License Number State | AK
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