NPI | 1104326172 |
---|---|
Doing Business As | AVITA PHARMACY |
Doing Business As | AVITA PHARMACY 1073 |
Entity Type | Organization |
Authorized Contact | CARL CODY COLQUITT Chief Financial Officer 469-850-6930 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2018-02-16 |
Last Update Date | 2022-07-06 |