| NPI | 1568963312 |
|---|---|
| Doing Business As | AVITA PHARMACY 1025 |
| Entity Type | Organization |
| Authorized Contact | KRISTEN GURLEY VP Legal Affairs 469-592-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 55894) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2024-06-14 |