Active NPI
Avita Drugs Alabama LLC
- Community/Retail Pharmacy
- Birmingham, AL
National Provider Identifier
1275184517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- AVITA DRUGS ALABAMA LLC
- Doing business as
- Avita Pharmacy
- Practice address
- 3220 5TH Ave S
Birmingham, AL 35222-2309 - Phone
- (205) 847-5390
- NPI assigned
- Sep 27, 2019
- 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
- Ryan Boyle
- Title
- Legal Counsel
- Phone
- (225) 236-1538
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
3220 5TH Ave S
Birmingham, AL 35222-2309
Mailing address
10604 Coursey Blvd
Baton Rouge, LA 70816-4015
Phone (225) 236-1541
Other names 1
- Avita Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230622003338 | AL | Part B Supplier - Pharmacy | 9830557883 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Birmingham, AL; Dothan, AL; Montgomery, AL |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Avita Drugs Alabama LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Dothan, AL
- NPI 1124854674
-
- Community/Retail Pharmacy
- Montgomery, AL
- NPI 1679277024
Locations
3220 5th Ave S
Ste 110
Birmingham, AL 35222
Phone (205) 847-5390
2500 4th Ave S
#A
Birmingham, AL 35233
2900 McGehee Rd
Ste C
Montgomery, AL 36111
Phone (334) 513-1162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569542400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733184000000",
"number": "1275184517",
"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",
"telephone_number": "225-236-1541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3220 5TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352222309",
"telephone_number": "205-847-5390"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVITA DRUGS ALABAMA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-27",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A",
"authorized_official_last_name": "BOYLE",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "LEGAL COUNSEL",
"authorized_official_telephone_number": "225-236-1538"
},
"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"
},
{
"organization_name": "Avita Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.