# AVITA DRUGS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AVITA DRUGS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710031166
- **Authorized official:** STEVE MOUBRY (VP OF FINANCE)
- **Authorized official phone:** (504) 737-4007

## Contact information

- **Practice address:** 6226 JEFFERSON HWY, STE G, HARAHAN, LA 70123-5153
- **Practice address phone:** (504) 737-4007
- **Practice address fax:** (504) 737-4008
- **Mailing address:** 6226 JEFFERSON HWY, STE G, HARAHAN, LA 70123-5153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 6048IR | LA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 02/12/2009