| NPI | 1154414597 | 
|---|---|
| Doing Business As | BROADWAY APOTHECARY | 
| Entity Type | Organization | 
| Authorized Contact | ANNE HARTHMAN Chief Clinical Officer, PIC 541-684-9352  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: AK PHAO1179)  | 
| Additional Taxonomies | 333600000X Pharmacy (Licence: HI PMP-792)  | 
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP-0001564)  | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: WA PHNR.FO.60312318)  | |
| Enumeration Date | 2006-09-30 | 
| Last Update Date | 2025-09-19 |