| NPI | 1114682382 |
|---|---|
| Doing Business As | BROADWAY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANDREW THOMAS HIBBARD President 541-449-9190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |