Pavilion Infusion Therapy Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1313883 Issued in FL

Legal business name

PAVILION INFUSION THERAPY INC

Practice address

6930 Bonneval Rd
Suite 3
Jacksonville, FL 32216

Phone

(904) 202-5760

Fax

(904) 281-0217

NPI assigned

Dec 13, 2012

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 2

Addresses

Other names 1

• Baptist Infusion Therapy Bonneval Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pavilion Infusion Therapy Inc

  • Home Infusion Therapy Pharmacy
  • Jacksonville, FL
  • NPI 1962413500

  8426179276

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Consol Oav Infusion the3 organizations share this tax ID, including this one

Part of

Consol Oav Infusion the

Other organizations with this tax ID 2

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

• Pavilion Infusion Therapy Inc

  • Home Infusion Therapy Pharmacy
  • Jacksonville, FL
  • NPI 1962413500
  NPD tax ID
• Baptist Home Care

  • Home Health Agency
  • NPI 1871619668
  NPD tax ID

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

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1447596853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 PRUDENTIAL DR STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078185",
            "telephone_number": "904-202-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 BONNEVAL RD",
            "address_2": "SUITE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-202-5760",
            "fax_number": "904-281-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION INFUSION THERAPY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAVILION INFUSION THERAPY INC",
        "enumeration_date": "2012-12-13",
        "last_updated": "2018-06-26",
        "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": "FL",
            "license": "1313883",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "1313883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Infusion Therapy Bonneval",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baptist Infusion Therapy Bonneval",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Lorna Santiago Paxson

• 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 Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.