Rav Pharma LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH31314 Issued in FL

Legal business name

RAV PHARMA LLC

Doing business as

Hometown Pharmacy

Practice address

450077 State Road 200 Ste 4
Callahan, FL 32011-3863

Phone

(904) 515-0929

Fax

(844) 324-8493

NPI assigned

May 3, 2018

Last updated

Jun 22, 2023By 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. Ashish Kapoor

Title

Officer

Phone

(904) 515-0929

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• HOMETOWN PHARMACY Doing business as

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1730678996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600786",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322600786",
            "telephone_number": "904-515-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450077 STATE ROAD 200 STE 4",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113863",
            "telephone_number": "904-515-0929",
            "fax_number": "844-324-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAV PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "KAPOOR",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "904-515-0929",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH31314",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177464",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOMETOWN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey J Price, BS
• Kiersten Lea Prince, D.O.
• Rav Pharma LLC (Hometown Pharmacy)
• Rav Pharma LLC (Hometown Pharmacy)
• Rav Pharma LLC (Hometown Pharmacy)
• Ryan Redwine, PT, DPT
• Jonathan Christopher Reed, PHARMD
• Linda Gail Reeves, CNA
• Kenneth Allen Rice, D.M.D.
• Rural Urgent Care LLC (MainStreet Family Care)

• Community/Retail Pharmacy in Callahan, FL
• Providers in Callahan, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.