BEAVERTON PHARMACY INC
12250 Sw Canyon Rd
Beaverton, OR 97005
503-644-2101
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 332B00000X | Suppliers - Durable Medical Equipment & Medical Supplies - | ||
N | 333600000X | Suppliers - Pharmacy | ||
N | 3336C0004X | Suppliers - Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | OR | RP-0000129-CS |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
007807 | OR | MEDICAID | |
PK | 2148247 | OTHER |