Organization
AVITA DRUGS LLC
Active
Other names
Avita Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ELLIS (CORPORATE COUBSEL)
(803) 254-5884
Entity
Organization
Contact information
Practice address
1715 COMMON ST STE A, LAKE CHARLES, LA 70601-6135
(337) 429-2817
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
02/14/2020
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