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Organization

AVITA DRUGS MISSISSIPPI, LLC

Active
Other names
Avita Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(803) 254-5884
Entity
Organization

Contact information

Practice address
805 E RIVER PL STE A, JACKSON, MS 39202-3486
(601) 336-1760
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
06/06/2019
Last updated
06/06/2019
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