Organization
AVITA DRUGS, LLC
Active
Organization
AVITA DRUGS, LLC
Active
Other names
Avita Pharmacy 1083
Organization subpart
No
Provider details
NPI number
Authorized official
CARL CODY COLQUITT (CHIEF FINANCIAL OFFICER)
(469) 850-6930
Entity
Organization
Contact information
Practice address
3406 BOB ROGERS DR STE 220, EAGLE PASS, TX 78852-5942
(830) 294-3264
Mailing address
5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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