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Organization

AVITA DRUGS LLC

Active
Parent organization
AVITA DRUGS LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
AVITA DRUGS LLC
Authorized official
CHAD BROOKER (SENIOR REGULATORY COUNSEL)
(469) 592-2010
Entity
Organization

Contact information

Practice address
117 CAILLOUETT PL STE A, LAFAYETTE, LA 70501-7807
(337) 443-7470
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHY.008441-RC
BOARD OF PHARMACY
LA
Enumeration date
03/22/2022
Last updated
03/22/2022
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