# BEACON HEALTH CARE SOLUTIONS INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598302119
- **Authorized official:** DR. ANDREW THOMAS HIBBARD PHARM.D (PRESIDENT AND CEO)
- **Authorized official phone:** (269) 599-0857

## Contact information

- **Practice address:** 2790 BROADWAY AVE, NORTH BEND, OR 97459-2216
- **Practice address phone:** (541) 808-0168
- **Mailing address:** 2790 BROADWAY AVE, NORTH BEND, OR 97459-2216
- **Mailing address phone:** (541) 808-0168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/02/2019
- **Last updated:** 10/13/2021