Organization
TRINITY COMPOUNDING PHARMACY
Active
Other names
BROADWAY APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE HARTHMAN (CHIEF CLINICAL OFFICER, PIC)
(541) 684-9352
Entity
Organization
Contact information
Practice address
1515 OAK ST, EUGENE, OR 97401-4790
(541) 684-9352
(541) 684-0858
Mailing address
1515 OAK ST, EUGENE, OR 97401-4790
(541) 684-9352
(541) 684-0858
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PMP-792
HI
3336C0003X
Community/Retail Pharmacy
RP-0001564
OR
3336C0004X
Compounding Pharmacy
Primary
PHAO1179
AK
3336C0004X
Compounding Pharmacy
PHNR.FO.60312318
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581038
—
AK
01
—
2079479
PK
—
05
—
2096620
—
WA
05
—
227829
—
OR
Enumeration date
09/30/2006
Last updated
09/19/2025
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