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Organization
AVITA DRUGS OREGON, LLC
Active
Organization
AVITA DRUGS OREGON, LLC
Active
Other names
Avita Pharmacy 1078
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(704) 641-7967
Entity
Organization
Contact information
Practice address
15 N MORRIS ST STE A, PORTLAND, OR 97227-1541
(469) 592-2011
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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