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General NPI Number Information
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NPI Number | 1730678996
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Entity Type | Organization
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Legal Business Name | RAV PHARMA LLC
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 450077 STATE ROAD 200 STE 4
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City | CALLAHAN
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State | FL
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Zip | 32011-3863
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Country | US
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Telephone | 904-515-0929
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Fax | 844-324-8493
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Provider Business Mailing Address
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Address Line | PO BOX 600786
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City | JACKSONVILLE
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State | FL
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Zip | 32260-0786
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Country | US
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Telephone | 904-515-0929
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MR. ASHISH KAPOOR
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Credential |
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Telephone | 904-515-0929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH31314
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License Number State | FL
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