# AVITA DRUGS ALABAMA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avita Pharmacy 1079
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679277024
- **Authorized official:** KRISTEN GURLEY (GENERAL COUNSEL)
- **Authorized official phone:** (469) 592-2011

## Contact information

- **Practice address:** 2567 FAIRLANE DR STE 100, MONTGOMERY, AL 36116-1643
- **Practice address phone:** (334) 513-1162
- **Mailing address:** 5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648
- **Mailing address phone:** (469) 592-2011

## Taxonomy

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

## Other

- **Enumeration date:** 03/29/2023
- **Last updated:** 03/31/2026