| NPI | 1043793029 |
|---|---|
| Doing Business As | AVITA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ASHLEY ELLIS Corporate Counsel 803-254-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2018-09-14 |