# AVITA DRUGS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avita Drugs LLC d/b/a Avita Pharmacy 1071
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306522891
- **Authorized official:** CARL CODY COLQUITT (CFO)
- **Authorized official phone:** (469) 850-6930

## Contact information

- **Practice address:** 600 PENNSYLVANIA AVE SE, WASHINGTON, DC 20003-4316
- **Practice address phone:** (202) 978-1565
- **Mailing address:** 5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648
- **Mailing address phone:** (469) 915-4843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/27/2023
- **Last updated:** 06/27/2023