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Organization

AVITA DRUGS LLC

Active
Other names
Avita Health
Organization subpart
No

Provider details

NPI number
Authorized official
MARSHALL FROST PHARMD (DIRECTOR OF IT & VENDOR MGMT)
(803) 254-5884
Entity
Organization

Contact information

Practice address
5551 CORPORATE BLVD, BATON ROUGE, LA 70808-2567
(844) 533-0588
(844) 533-0607
Mailing address
5551 CORPORATE BLVD, BATON ROUGE, LA 70808-2567
(844) 533-0588
(844) 533-0607

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY006081IR
LA
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2156092
PK
Enumeration date
12/29/2015
Last updated
08/02/2016
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