Av 1 Pharma LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

AV 1 PHARMA LLC

Practice address

164 S US Highway 17 Ste 10
East Palatka, FL 32131-4066

Phone

(904) 506-0060

Fax

(904) 515-5795

NPI assigned

Oct 13, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Reena Chadha

Title

Authorized Official

Phone

(904) 506-0060

Specialties & licenses 2

Addresses

Other names 1

• PALATKA PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1912418286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600861",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322600861",
            "telephone_number": "904-386-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 S US HIGHWAY 17 STE 10",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314066",
            "telephone_number": "904-506-0060",
            "fax_number": "904-515-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV 1 PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "CHADHA",
        "authorized_official_first_name": "REENA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "904-506-0060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALATKA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in East Palatka, FL
• Providers in East Palatka, 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.