Organization
AVITA DRUGS TENNESSEE, LLC
Active
Organization
AVITA DRUGS TENNESSEE, LLC
Active
Other names
Avita Pharmacy 1065
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN BOYLE (REGULATORY COUNSEL)
(225) 236-1538
Entity
Organization
Contact information
Practice address
1005 DR. B. TODD JR. BLVD, SUITE 332, NASHVILLE, TN 37208
(321) 369-9495
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(225) 236-1541
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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