Pavilion Infusion Therapy Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAVILION INFUSION THERAPY INC

Practice address

1301 Palm Avenue
Suite 220
Jacksonville, FL 32207

Phone

(904) 202-5887

NPI assigned

Jun 27, 2018

Organization subpart

Yes

Parent organization

PAVILION INFUSION THERAPY INCAs reported in NPPES

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

Authorized official

Name

Christopher Robert Durkin, FHFMA

Title

VP

Phone

(904) 202-5887

Specialties & licenses 1

Addresses

Other names 1

• Life Center Other name

Part of

Consol Oav Infusion the

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pavilion Infusion Therapy Inc

  • Home Infusion Therapy Pharmacy
  • Jacksonville, FL
  • NPI 1962413500
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha L Shaw

  • Physician Assistant
  • Tallmadge, OH
  • NPI 1881484004
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1073008504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 PRUDENTIAL DRIVE",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-202-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVENUE",
            "address_2": "SUITE 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-202-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION INFUSION THERAPY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAVILION INFUSION THERAPY INC",
        "enumeration_date": "2018-06-27",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "DURKIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "904-202-5887",
        "authorized_official_credential": "FHFMA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Life Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wilford E. Paulk, M.D.
• Anjelica M Paulo, M.S., BCBA
• John Lewis Pauls
• Shenelle Paulson, ARNP
• Matthew G Paulus, A.T.
• Pavilion Infusion Therapy Inc
• Pavilion Infusion Therapy Inc
• Gregory G Pavlat, M. D.
• Nancy D Pawlukiewicz, PHARM.D.
• Paxon Prescription Center Inc

• Durable Medical Equipment & Medical Supplies in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.