# AVITA DRUGS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avita Pharmacy 1085
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679363071
- **Authorized official:** KRISTEN GURLEY (GENERAL COUNSEL)
- **Authorized official phone:** (469) 592-2011

## Contact information

- **Practice address:** 3635 N HALSTED ST, CHICAGO, IL 60613-4315
- **Practice address phone:** (872) 710-6132
- **Mailing address:** 5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648
- **Mailing address phone:** (469) 592-2011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2025
- **Last updated:** 05/08/2025