| NPI | 1629435565 |
|---|---|
| Doing Business As | AVITA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARSHALL FROST Director Of It & Vendor Mgmt 803-254-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007212-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2018-07-19 |