Organization · NPI-2
Avita Drugs LLC
Pharmacy, Community/Retail Pharmacy · Lafayette, LA
NPI number1780333229
StatusActive
Last updated in NPPESMar 22, 2022
Details
- NPI
- 1780333229
- Entity type
- Organization (NPI-2)
- Legal business name
- Avita Drugs LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 22, 2022
- Certification date
- Mar 22, 2022
- Last updated
- Mar 22, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
Practice location
117 Caillouett Pl Ste ALafayette, LA 70501-7807
Phone 337-443-7470
Mailing address
10604 Coursey BlvdBaton Rouge, LA 70816-4015
Authorized official
Chad Brooker
Senior Regulatory Counsel
4695922010
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