Avita Drugs
LBN: 340B Partners Pharmacy - Dallas Llc
Avita Drugs is an health care organization with primary practice located at 750 Fort Worth Ave Ste H100 , Dallas TX 75208-1811. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
340B Partners Pharmacy - Dallas Llc can be contacted via phone (972) 805-5960, or through Ellis, Ashley via phone (803) 254-5884.
Contact Information
Primary practice address
750 Fort Worth Ave Ste H100
Dallas TX 75208-1811
Phone: (972) 805-5960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 27717 | Texas |
Profile Details
| NPI number | 1962784900 |
|---|---|
| LBN Legal business name | 340B Partners Pharmacy - Dallas Llc |
| DBA Doing business as | Avita Drugs |
| Authorized official | Ellis, Ashley |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2011 |
| Last updated | Oct 26th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962784900 | NPPES |
| Texas | MEDICAID | 148897 | |
| Texas | Other | 2131953 |
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