Avita Pharmacy 1077 is an authorized DME supplier for medicare equipments and products.
Avita Pharmacy 1077 is a Community/Retail Pharmacy in San Antonio, Texas. This pharmacy is owned and operated by Avita Drugs, Llc. It is located at 2602 N Main Ave, San Antonio and it's customer support contact number is 210-736-3161. The authorized person of Avita Pharmacy 1077 is Carl Cody Colquitt who is Chief Financial Officer of the pharmacy and his contact number is 469-592-2011. Active license number of Avita Pharmacy 1077 is 01935 for Community/Retail Pharmacy in Texas. Avita Pharmacy 1077 accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance. Avita Pharmacy 1077 is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Avita Pharmacy 1077 type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name:
Avita Pharmacy 1077
Type:
Community/Retail Pharmacy
Location:
2602 N Main Ave, San Antonio, Texas, 78212-2919
Phone:
210-736-3161
Fax:
210-736-3175
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name:
Carl Cody Colquitt
Position:
Chief Financial Officer
Contact Number:
469-592-2011
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number:
1295888949
NPI Enumeration Date:
18 Jan, 2007
NPI Last Update On:
31 Jan, 2024
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Avita Pharmacy 1077 are as mentioned below.
Specialization
License Number
State
Status
Community/Retail Pharmacy
01935
Texas
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
130275
Medicaid
Texas
Medicare Enrollment:
Avita Pharmacy 1077 is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID:
Enrollment ID:
Org Name
Medicare Entity Type
3375705122
O20120424000572
Slg Pharmacy Llc
DME SUPPLIER - PHARMACY
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
5700 Granite Parkway, Suite 425 Plano, Texas
Zip:
75024-6648
Phone Number:
469-592-2011
Fax Number:
210-736-3175
Patients can reach Avita Pharmacy 1077 at 2602 N Main Ave, San Antonio, Texas or can call on customer care at 210-736-3161.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.
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