Organization
340B PARTNERS PHARMACY LLC
Active
Other names
AVITA DRUGS
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
303 N FRIO ST STE 102, SAN ANTONIO, TX 78207-3034
(210) 231-0383
(210) 231-0462
Mailing address
303 N FRIO ST STE 102, SAN ANTONIO, TX 78207-3034
(210) 231-0383
(210) 231-0462
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26065
TX
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148616
—
TX
01
—
2101428
PK
—
Enumeration date
06/09/2008
Last updated
10/07/2024
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