| NPI | 1679277024 |
|---|---|
| Doing Business As | AVITA PHARMACY 1079 |
| Entity Type | Organization |
| Authorized Contact | KRISTEN GURLEY Vice President, Legal Affairs 469-915-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |