Av Pharma LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

AV PHARMA LLC

Doing business as

Citizen Pharmacy # 712

Practice address

1545 University Blvd N Ste C
Jacksonville, FL 32211-5229

Phone

(904) 440-0611

Fax

(904) 323-4083

NPI assigned

Oct 13, 2017

Last updated

Dec 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Vipul Mamtora

Title

Member Manager

Phone

(904) 440-0611

Specialties & licenses 1

Addresses

Other names 1

• CITIZEN PHARMACY # 712 Doing business as

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.

• Av Pharma LLC

  dba Citizen Pharmacy

  • Community/Retail Pharmacy
  • Jacksonville, FL
  • NPI 1033870209
  NPD tax ID
• Av Pharma LLC

  dba Citizen Pharmacy

  • Pharmacy
  • Jacksonville, FL
  • NPI 1184003311
  NPD tax ID

Locations

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1629589908",
    "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": "904-440-0611",
            "fax_number": "904-323-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 UNIVERSITY BLVD N STE C",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115229",
            "telephone_number": "904-440-0611",
            "fax_number": "904-323-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "MAMTORA",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "904-440-0611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CITIZEN PHARMACY # 712",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Autumn Village, Inc.
• James Kurt Auwaerter, PT
• Av Pharma LLC (Citizen Pharmacy)
• Av Pharma LLC (Citizen Pharmacy)
• Av Pharma LLC (Foursquare RX Hub)
• Ramya Avadhanam
• Nicole Elizabeth Avalon, P.A.-C
• Aruna Avanti
• Avantzi Integrative Behavioral Health LLC
• Avecina Medical

• Compounding Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.