| NPI | 1962816223 |
|---|---|
| Doing Business As | AVITA SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARSHALL FROST Director Of It & Vendor Mgmt 803-254-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: LA PHY.006081-IR) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2016-08-02 |