NPI | 1275030645 |
---|---|
Doing Business As | AVITA PHARMACY |
Entity Type | Organization |
Authorized Contact | ASHLEY ELLIS Corporate Counsel/AO 704-641-7967 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: SC 17812) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2018-04-11 |
Last Update Date | 2018-06-27 |