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General NPI Number Information
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NPI Number | 1154598266
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Entity Type | Organization
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Legal Business Name | AVITA DRUGS LLC
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 6100 CORPORATE BLVD STE 250
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City | BATON ROUGE
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State | LA
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Zip | 70808-2723
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Country | US
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Telephone | 225-924-1930
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Fax | 225-924-2620
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Provider Business Mailing Address
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Address Line | 10604 COURSEY BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-4015
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Country | US
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Telephone | 225-236-1540
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Fax | 225-663-2158
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | KRISTEN GURLEY
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Credential |
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Telephone | 469-592-2011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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