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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1780234567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVITA DRUGS LLC

Provider Business Mailing Address
First Line	:	10604 COURSEY BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 COMMON ST STE A
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-6135
Country	:	US
Telephone Number	:	337-429-2817
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE COUBSEL
Name	:	ASHLEY ELLIS
Credential	:
Telephone Number	:	803-254-5884

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	02/14/2020

Similar Medicare Providers

1558431106 — SOUTHWEST LOUISIANA AIDS COUNCIL
Practice Location Address:

1715 COMMON ST
LAKE CHARLES, LA
70601-6135

Practice Phone: 337-439-5861
Practice Fax: 337-436-8713

1396413274 — KA'DEA WADE-GEORGE FNP
Practice Location Address:

1715 COMMON ST
LAKE CHARLES, LA
70601-6135

Practice Phone: 337-439-5861
Practice Fax:

1013752369 — SONIA OGEANI
Practice Location Address:

1715 COMMON ST
LAKE CHARLES, LA
70601-6135

Practice Phone: 337-429-2814
Practice Fax:

1265267066 — LEXSUS LEVINGS
Practice Location Address:

1715 COMMON ST
LAKE CHARLES, LA
70601-6135

Practice Phone: 337-439-1386
Practice Fax: 337-439-5875

1871525667 — NNAMDI ANDREW NWABUEZE M.D.
Practice Location Address:

3050 CHARLES DR
JACKSON, LA
70748-6135

Practice Phone: 225-634-3517
Practice Fax:

1114047735 — NWABUEZE NNAMDI INC
Practice Location Address:

3050 CHARLES DR
JACKSON, LA
70748-6135

Practice Phone: 225-634-3517
Practice Fax: 225-635-5057

Directions to “AVITA DRUGS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.