| NPI | 1639651490 |
|---|---|
| Doing Business As | BEAVERTON PHARMACY |
| Entity Type | Organization |
| Authorized Contact | THOMAS WADE IRBY President 503-644-2101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: OR RP-0000129-CS) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |