Avni Inc

Key facts

NPI

1275919086

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

P06847 (MD)

Legal business name

AVNI INC

Practice address

2702 Back Acre Cir Ste 190-B
Mount Airy, MD 21771-7769

Phone

(301) 703-8836

Fax

(301) 703-8876

NPI assigned

Aug 4, 2015

Organization subpart

No

Authorized official

Name

Kimberly Lizardo NPI 1508204819

Title

Pharmacist in Charge

Phone

(301) 703-8836

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Kimberly S Lizardo, PHARM.D. Pharmacist · Mount Airy, MD · NPI 1508204819
  NPD (past) Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Avni Apothecary Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 13, 2016.

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1275919086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 BACK ACRE CIR",
            "address_2": "SUITE 190-B",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717769",
            "telephone_number": "301-703-8836",
            "fax_number": "301-703-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 BACK ACRE CIR STE 190-B",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717769",
            "telephone_number": "301-703-8836",
            "fax_number": "301-703-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVNI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "LIZARDO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "301-703-8836"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avni Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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