| NPI | 1225409238 |
|---|---|
| Doing Business As | AVITA PHARMACY 1008 |
| Entity Type | Organization |
| Authorized Contact | DALILA IBARRA Licensing & Credentialing Coordinat 657-286-7957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 53621) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2024-03-14 |