| NPI | 1306522891 |
|---|---|
| Doing Business As | AVITA DRUGS LLC D/B/A AVITA PHARMACY 1071 |
| Entity Type | Organization |
| Authorized Contact | CARL CODY COLQUITT CFO 469-850-6930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |