Organization
AVITA DRUGS LLC
Active
Other names
AVITA SPECIALTY PHARMACY
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
5551 CORPORATE BLVD STE 102, BATON ROUGE, LA 70808-2512
(225) 924-1930
(225) 924-2620
Mailing address
5551 CORPORATE BLVD, SUITE 102, BATON ROUGE, LA 70808-2567
(225) 924-1930
(225) 924-2620
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
PHY.006081-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146281
PK
—
Enumeration date
06/16/2014
Last updated
08/02/2016
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