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AVITA PHARMACY 1077
NPI 1295888949
Pharmacy - Community/Retail Pharmacy in San Antonio, TX

Active since January 18, 2007
2602 N MAIN AVE, SAN ANTONIO, TX 78212(210) 736-3161(210) 736-3175 Get Directions Write a Review

NPPES record last updated: January 31, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Avita Pharmacy 1077 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVITA PHARMACY 1077 (NPI 1295888949) is a healthcare organization registered as a community/retail pharmacy in San Antonio, Texas and active in the NPI registry since January 2007. The organization lists Carl Cody Colquitt, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1295888949
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameAVITA DRUGS, LLC
Location Address2602 N MAIN AVESan Antonio, TX 78212-2919
Mailing Address5700 Granite Parkway, Suite 425Plano, TX 75024-6648 · (469) 592-2011 · Fax (210) 736-3175
Phone(210) 736-3161
Fax(210) 736-3175
Organization SubpartNo
Authorized OfficialCarl Cody ColquittChief Financial Officer · (469) 592-2011
Enumeration DateJanuary 18, 2007
Last NPPES UpdateJanuary 31, 2024
NPPES CertifiedJanuary 31, 2024
✔ NPI 1295888949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 01935
Definition
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.
2602 N MAIN AVE, San Antonio, TX 78212
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Other Names 1

Doing Business AsAvita Pharmacy 1077

Other Identifiers 1

Medicaid130275TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Avita Pharmacy 1077 carries, from the Medicare DMEPOS supplier directory.

Avita Pharmacy 1077

DMEPOS supplier · San Antonio, TXOperated by Avita Drugs LLC
⋮

Does not accept Medicare assignment

Avita Pharmacy 1077 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)26716522
Medicare Participant SinceApril 6, 2005
Supplier Location2602 N Main AveSan Antonio, TX 78212
Phone(210) 736-3161
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMATHA SHASHI RAVI RUDRANGI
Pharmacist
2602 N MAIN AVE
SAN ANTONIO, TX 78212
Bexar County (210) 736-3161
SLG PHARMACY LLC
Pharmacy (Long Term Care Pharmacy)
2602 N MAIN AVE
SAN ANTONIO, TX 78212
Bexar County (210) 736-3161
SLG PHARMACY LLC
Pharmacy (Specialty Pharmacy)
2602 N MAIN AVE
SAN ANTONIO, TX 78212
Bexar County (210) 881-0890

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avita Drugs, LLC's NPI number?

The NPI number for Avita Drugs, LLC is 1295888949. It was assigned to this organization in the NPPES registry on January 18, 2007. The provider is doing business as Avita Pharmacy 1077.

Where is Avita Drugs, LLC located?

Avita Drugs, LLC is located at 2602 N Main Ave, San Antonio, TX 78212. The listed phone number is (210) 736-3161.

What is Avita Drugs, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Avita Drugs, LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Avita Pharmacy 1077 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Avita Drugs, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 57 other insurers list Avita Drugs, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Avita Drugs, LLC was last updated on January 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.