Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
BEACON HEALTH CARE SOLUTIONS INCORPORATED
Active
Organization
BEACON HEALTH CARE SOLUTIONS INCORPORATED
Active
Other names
Broadway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW THOMAS HIBBARD PHARM.D (PRESIDENT AND CEO)
(269) 599-0857
Entity
Organization
Contact information
Practice address
2790 BROADWAY AVE, NORTH BEND, OR 97459-2216
(541) 808-0168
Mailing address
2790 BROADWAY AVE, NORTH BEND, OR 97459-2216
(541) 808-0168
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
NULL
333600000X
Pharmacy
Primary
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
12/02/2019
Last updated
10/13/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers