| NPI | 1780234567 |
|---|---|
| Doing Business As | AVITA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ASHLEY ELLIS Corporate Coubsel 803-254-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2020-02-14 |