Organization
AVITA DRUGS, LLC
Active
Parent organization
AVITA DRUGS LLC
Other names
Avita Pharmacy 1073, Avita Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVITA DRUGS LLC
Authorized official
CARL CODY COLQUITT (CHIEF FINANCIAL OFFICER)
(469) 850-6930
Entity
Organization
Contact information
Practice address
300 S 2ND ST STE 102, MCALLEN, TX 78501-2702
(512) 729-0020
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(225) 236-1543
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31960
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
02/16/2018
Last updated
07/06/2022
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