Active NPI
Avita Drugs, LLC
Doing business as Avita Pharmacy
- Community/Retail Pharmacy
- New Orleans, LA
National Provider Identifier
1043793029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- AVITA DRUGS, LLC
- Doing business as
- Avita Pharmacy
- Practice address
- 1631 Elysian Fields Ave
Suite 200
New Orleans, LA 70117 - Phone
- (504) 620-0670
- NPI assigned
- Sep 14, 2018
- Last updated
- Sep 14, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ashley Ellis
- Title
- Corporate Counsel
- Phone
- (803) 254-5884
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1631 Elysian Fields Ave
Suite 200
New Orleans, LA 70117
Mailing address
10604 Coursey Blvd
Baton Rouge, LA 70816-4015
Other names 1
- Avita Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241031000054 | LA | Part B Supplier - Pharmacy | 4789895129 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Orleans, LA; Lake Charles, LA; Lafayette, LA |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Avita Pharmacy
- Community/Retail Pharmacy
- New Orleans, LA
- NPI 1629435565
O20241031000054
National Provider Directory
National Provider Directory- Tax ID family
- Avita Drugs LLC
Other organizations with this tax ID 20
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Harahan, LA
- NPI 1710031166
-
- Community/Retail Pharmacy
- Lafayette, LA
- NPI 1780333229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1536883200000",
"number": "1043793029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10604 COURSEY BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708164015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 ELYSIAN FIELDS AVE",
"address_2": "SUITE 200",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70117",
"telephone_number": "504-620-0670"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVITA DRUGS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-14",
"last_updated": "2018-09-14",
"status": "A",
"authorized_official_last_name": "ELLIS",
"authorized_official_first_name": "ASHLEY",
"authorized_official_title_or_position": "CORPORATE COUNSEL",
"authorized_official_telephone_number": "803-254-5884"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Avita Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in New Orleans, LA
- Ashton Taylor Averitt, CRNA
- Emily Lynch Avgerinos, MD
- Diego H. Aviles, MD
- Avita Drugs LLC (Avita Pharmacy)
- Avita Drugs LLC (Avita Pharmacy)
- Noor Awad, MD
- Awakening Dormant Minds LLC
- Awesome Medical Equipment and Healthcare Management Services Inc.
- Richard W Awtrey Jr., M.D.
- Kellie Scott Axelrad, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.