Organization · NPI-2

340b Partners Pharmacy - Dallas LLC

Pharmacy, Community/Retail Pharmacy · Dallas, TX

NPI number1962784900
StatusActive
Last updated in NPPESOct 26, 2020

Details

NPI
1962784900
Entity type
Organization (NPI-2)
Legal business name
340b Partners Pharmacy - Dallas LLC
Organization subpart
No
Enumeration date
Sep 15, 2011
Certification date
Oct 26, 2020
Last updated
Oct 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy27717TXYes
333600000X Pharmacy––

Other names

  • Avita Drugs (Doing Business As)

Practice location

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

Phone 972-805-5960

Mailing address

10604 Coursey Blvd
Baton Rouge, LA 70816

Phone 225-924-1930 · Fax 225-924-3217

Other practice locations

219 Sunset Ave Ste 118a
Dallas, TX 75208-4500

Phone 214-943-5187 · Fax 972-807-2657

Authorized official

Ashley Ellis
Corporate Counsel
8032545884

Is something wrong?

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