NPIMap

Organization Active NPI

Av Pharma LLC

Doing business as Citizen Pharmacy

  • Community/Retail Pharmacy
  • Jacksonville, FL
National Provider Identifier
1033870209
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
AV PHARMA LLC
Doing business as
Citizen Pharmacy
Practice address
1545 University Blvd N
Jacksonville, FL 32211-5229
Phone
(904) 619-3776
Fax
(844) 324-8493
NPI assigned
Jan 10, 2022
Last updated
Aug 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vipul B MamtoraNPI 1902929565
Title
Director
Phone
(844) 224-8493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X NU Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1545 University Blvd N
Jacksonville, FL 32211-5229

Mailing address

PO Box 600047
Jacksonville, FL 32260-0047
Phone (904) 619-3776

Other identifiers 1

IdentifierTypeStateIssuer
117117700MedicaidFL

Other names 1

  • Citizen Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Av Pharma LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1545 University Blvd N
Ste A
Jacksonville, FL 32211
Phone (844) 224-8493

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1033870209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600047",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322600047",
            "telephone_number": "904-619-3776",
            "fax_number": "844-324-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115229",
            "telephone_number": "904-619-3776",
            "fax_number": "844-324-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "MAMTORA",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "844-224-8493"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117117700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citizen Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.