| NPI | 1437871506 |
|---|---|
| Doing Business As | AVITA PHARMACY 1046 |
| Entity Type | Organization |
| Authorized Contact | ASHLEY ELLIS Corporate Counsel 704-641-7967 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |