Organization
AVITA DRUGS KENTUCKY, LLC
Active
Other names
Avita Pharmacy 1081
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN GURLEY (VICE PRESIDENT, LEGAL AFFAIRS)
(469) 592-2011
Entity
Organization
Contact information
Practice address
1101 E WASHINGTON ST STE A, LOUISVILLE, KY 40206-1822
(469) 592-2011
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
08/16/2023
Last updated
08/16/2023
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