NPI 1548217136 · live from the CMS NPI Registry
Beaverton Pharmacy INC
Pharmacy, Community/Retail Pharmacy in Beaverton, OR. National Provider Identifier 1548217136, active.
NPI record
| NPI | 1548217136 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 12250 Sw Canyon Rd, Beaverton, OR 97005 |
| Practice phone | 503-644-2101 |
| Enumerated | May 28, 2006 |
| Last updated | December 12, 2019 |
| Authorized official | Thomas Irby, President |
| Other names | Beaverton Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Compounding Pharmacy | 3336C0004X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | RP-0000129-CS (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.