| NPI | 1760250567 |
|---|---|
| Doing Business As | AVITA PHARMACY 1078 |
| Entity Type | Organization |
| Authorized Contact | ASHLEY ELLIS Corporate Counsel 704-641-7967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2023-12-12 |