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AV PHARMA LLC
NPI 1629589908
Pharmacy - Compounding Pharmacy in Jacksonville, FL

Active since October 13, 2017
1545 UNIVERSITY BLVD N STE C, JACKSONVILLE, FL 32211(904) 440-0611(904) 323-4083 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 15, 2025, Aug 5, 2019, Jul 25, 2019 and 2 more (5 updates tracked since 2017).

About Av Pharma Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AV PHARMA LLC (NPI 1629589908), doing business as Citizen Pharmacy # 712, is a healthcare organization registered as a compounding pharmacy in Jacksonville, Florida and active in the NPI registry since October 2017. The organization lists Vipul Mamtora, Member Manager, as its authorized official.

NPPES Registry Identity

NPI1629589908
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameAV PHARMA LLC
Location Address1545 UNIVERSITY BLVD N STE CJacksonville, FL 32211-5229
Mailing AddressPo Box 600047Jacksonville, FL 32260-0047 · (904) 440-0611 · Fax (904) 323-4083
Phone(904) 440-0611
Fax(904) 323-4083
Organization SubpartNo
Authorized OfficialVipul MamtoraMember Manager · (904) 440-0611
Enumeration DateOctober 13, 2017
Last NPPES UpdateDecember 15, 20255 updates tracked since enumeration
NPPES CertifiedDecember 15, 2025
✔ NPI 1629589908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
1545 UNIVERSITY BLVD N STE C, Jacksonville, FL 32211
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Other Names 1

Doing Business AsCitizen Pharmacy # 712

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Av Pharma LLC's NPI number?

The NPI number for Av Pharma LLC is 1629589908. It was assigned to this organization in the NPPES registry on October 13, 2017. The provider is doing business as Citizen Pharmacy # 712.

Where is Av Pharma LLC located?

Av Pharma LLC is located at 1545 University Blvd N Ste C, Jacksonville, FL 32211. The listed phone number is (904) 440-0611.

What is Av Pharma LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Av Pharma LLC was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.