Organization · Type 2 NPI

Beaverton Pharmacy Inc

Long Term Care Pharmacy · Beaverton, OR

NPI number 1639651490 Active

Practice location

12250 SW Canyon Rd
Beaverton, OR 97005-2116

Specialties and licenses

Taxonomy	Code	License
Long Term Care Pharmacy Primary	3336L0003X	RP-0000129-CS (OR)

Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

5 other providers at this address

Other long term care pharmacy providers in Beaverton

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NPI record

NPI: 1639651490
Entity type: Organization (Type 2)
Issued: Aug 29, 2018
Last updated: Aug 29, 2018
Status: Active
Subpart: Yes of Beaverton Pharmacy Inc

Other names

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Beaverton Pharmacy · doing business as
Beaverton Pharmacy · doing business as

Authorized official

Thomas Wade Irby, RPH
President
(503) 644-2101

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639651490

Beaverton Pharmacy Inc's National Provider Identifier is 1639651490, issued on Aug 29, 2018. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Beaverton, OR. The record was last updated on Aug 29, 2018.