Broadway Apothecary
LBN: Trinity Compounding Pharmacy
Broadway Apothecary is an health care organization with primary practice located at 1515 Oak St , Eugene OR 97401-4790. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty.
Trinity Compounding Pharmacy can be contacted via phone (541) 684-9352, or through Harthman, Anne via phone (541) 684-9352.
Contact Information
Primary practice address
1515 Oak St
Eugene OR 97401-4790
Phone: (541) 684-9352
Fax: (541) 684-0858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | PMP-792 | Hawaii |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | RP-0001564 | Oregon |
| Suppliers / Compounding Pharmacy | 3336C0004X | PHNR.FO.60312318 | Washington |
| Suppliers / Compounding Pharmacy | 3336C0004X | PHAO1179 | Alaska |
Profile Details
| NPI number | 1154414597 |
|---|---|
| LBN Legal business name | Trinity Compounding Pharmacy |
| DBA Doing business as | Broadway Apothecary |
| Authorized official | Harthman, Anne |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 30th, 2006 |
| Last updated | Jul 19th, 2018 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154414597 | NPPES |
| Oregon | MEDICAID | 227829 | |
| Oregon | Other | 2079479 | |
| Oregon | MEDICAID | 1581038 | |
| Oregon | MEDICAID | 2096620 |
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