Organization
AVITA DRUGS OREGON, LLC
Active
Other names
Avita Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(803) 978-9068
Entity
Organization
Contact information
Practice address
2236 SE BELMONT ST STE A, PORTLAND, OR 97214-2817
(503) 379-0370
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(704) 641-7967
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
11/24/2025
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