Provider Demographics
NPI:1265002760
Name:AVERT LLC
Entity Type:Organization
Organization Name:AVERT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:UZOAMAKA
Authorized Official - Middle Name:MODESTA
Authorized Official - Last Name:ODUH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:561-574-9168
Mailing Address - Street 1:2218 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-6101
Mailing Address - Country:US
Mailing Address - Phone:561-729-0857
Mailing Address - Fax:
Practice Address - Street 1:2218 S JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-6101
Practice Address - Country:US
Practice Address - Phone:561-729-0857
Practice Address - Fax:561-516-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy