| NPI | 1174779219 |
|---|---|
| Doing Business As | AVITA PHARMACY 1051 |
| Entity Type | Organization |
| Authorized Contact | ASHLEY ELLIS Corporate Counsel 803-254-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AK 108052) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y006749) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: DC NRX0000789) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 320011982) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHNR000221) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY SC1980) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: HI 1240) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH29285) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 41111MS) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 64002113A) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 4658) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT PCN.0003017) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO OSP.0006745) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: DE 11597) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007436-NR) | |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2021-05-12 |