MEDICARE: AVITA DRUGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1215882675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVITA DRUGS LLC

Provider Business Mailing Address
First Line	:	5700 GRANITE PKWY STE 425
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	857 E WASHINGTON ST STE D
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-5939
Country	:	US
Telephone Number	:	956-426-3046
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	KRISTEN GURLEY
Credential	:
Telephone Number	:	469-592-2011

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “AVITA DRUGS LLC ” Practice Location

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