NPI | 1841467594 |
---|---|
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.006060-IR) |
Additional Taxonomies | 333600000X Pharmacy |
3336L0003X Pharmacy, Long Term Care Pharmacy | |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2008-05-13 |
Last Update Date | 2024-10-21 |