Provider Demographics
NPI:1538642434
Name:AVS PHARMACY LLC
Entity type:Organization
Organization Name:AVS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELA
Authorized Official - Middle Name:AJAY
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:571-263-5805
Mailing Address - Street 1:13336 POINT RIDER LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3810
Mailing Address - Country:US
Mailing Address - Phone:571-213-7998
Mailing Address - Fax:
Practice Address - Street 1:161 FORT EVANS RD NE STE 115
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3370
Practice Address - Country:US
Practice Address - Phone:571-213-7998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-07
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy