Organization
340B PARTNERS PHARMACY - DALLAS LLC
Active
Parent organization
AVITA DRUGS, LLC
Other names
Avita Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVITA DRUGS, LLC
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(803) 254-5884
Entity
Organization
Contact information
Practice address
2800 S IH 35 FRONTAGE RD, SUITE 105, AUSTIN, TX 78704
(512) 213-4030
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(225) 236-1541
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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