| NPI | 1891107066 |
|---|---|
| Doing Business As | AVITA PHARMACY 1001 |
| Entity Type | Organization |
| Authorized Contact | DALILA IBARRA Licensing & Credentialing Coordinat 657-286-7957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA 51788) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-09-12 |