Pavilion Infusion Therapy Inc

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PH13801 Issued in FL

Legal business name

PAVILION INFUSION THERAPY INC

Practice address

3563 Philips Hwy
Ste 202
Jacksonville, FL 32207-5663

Phone

(904) 202-5730

Fax

(904) 398-2225

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Christopher Durkin, FHFMA

Title

VP

Phone

(904) 202-5887

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Baptist Infusion Therapy 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

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1447596853

  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

Other organizations with this tax ID 2

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

• Pavilion Infusion Therapy Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1447596853
  NPD tax ID
• Baptist Home Care

  • Home Health Agency
  • NPI 1871619668
  NPD tax ID

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pavilion Infusion Therapy Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1073008504
  NPPES parent name
• Pavilion Infusion Therapy Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1447596853
  NPPES parent name

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1962413500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3563 PHILIPS HWY",
            "address_2": "STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075663",
            "telephone_number": "904-202-5730",
            "fax_number": "904-398-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3563 PHILIPS HWY",
            "address_2": "STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075663",
            "telephone_number": "904-202-5730",
            "fax_number": "904-398-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION INFUSION THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "DURKIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "FL",
            "license": "PH13801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102335700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2011769",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Infusion Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Madison Paige Paxton, M.S., CF-SLP

• Home Infusion Therapy Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Home Infusion Therapy Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.