Provider Demographics
NPI:1750028130
Name:ANOVORX GROUP LLC
Entity Type:Organization
Organization Name:ANOVORX GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-201-5470
Mailing Address - Street 1:1710 SHELBY OAKS DR N STE 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7403
Mailing Address - Country:US
Mailing Address - Phone:901-201-5470
Mailing Address - Fax:901-201-5465
Practice Address - Street 1:17500 SOUTH 40TH ST, BUILDING B
Practice Address - Street 2:SUITE 600A
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2572
Practice Address - Country:US
Practice Address - Phone:901-201-5470
Practice Address - Fax:901-201-5465
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANOVORX GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy