| NPI | 1295888949 |
|---|---|
| Doing Business As | AVITA PHARMACY 1077 |
| Entity Type | Organization |
| Authorized Contact | CARL CODY COLQUITT Chief Financial Officer 469-592-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 01935) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-01-31 |