| 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 | 2018-07-19 |