Organization · NPI-2

340b Partners Pharmacy - Dallas LLC

Pharmacy, Community/Retail Pharmacy · Dallas, TX

NPI number1790014124
StatusActive
Last updated in NPPESOct 7, 2024

Details

NPI
1790014124
Entity type
Organization (NPI-2)
Legal business name
340b Partners Pharmacy - Dallas LLC
Organization subpart
No
Enumeration date
Dec 14, 2009
Certification date
Oct 7, 2024
Last updated
Oct 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy26681TXYes
3336S0011X Pharmacy, Specialty Pharmacy––

Other names

  • Avita Drugs (Doing Business As)

Practice location

750 Fort Worth Ave Ste H100
Dallas, TX 75208-1811

Phone 214-943-5187 · Fax 972-807-2657

Mailing address

411 Colonial Dr
Baton Rouge, LA 70806-6506

Phone 214-780-0898 · Fax 214-780-0953

Authorized official

Carl Colquitt
Cfo
4695922005

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