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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