| NPI | 1598302119 |
|---|---|
| Doing Business As | BROADWAY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANDREW THOMAS HIBBARD President And CEO 269-599-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2021-10-13 |