Beaverton Pharmacy

LBN: Beaverton Pharmacy Inc
Beaverton Pharmacy is an health care organization with primary practice located at 12250 Sw Canyon Rd , Beaverton OR 97005-2116. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Beaverton Pharmacy Inc can be contacted via phone (503) 644-2101, or through Irby, Thomas via phone (503) 644-2101.

Contact Information

Primary practice address
12250 Sw Canyon Rd Beaverton OR 97005-2116
Phone: (503) 644-2101
Fax: (503) 626-8698
Website:
Map and Directions
Authorized official contact:
Name: Irby, Thomas
Phone: (503) 644-2101

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X RP-0000129-CS Oregon
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1548217136
LBN Legal business name Beaverton Pharmacy Inc
DBA Doing business as Beaverton Pharmacy
Authorized official Irby, Thomas
Entity Organization
Organization subpart 1 No
Enumeration date May 28th, 2006
Last updated Dec 12th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548217136 NPPES
Other 2148247 PK
MEDICAID 007807 PK

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