Beacon Health Care Solutions Incorporated

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BEACON HEALTH CARE SOLUTIONS INCORPORATED

Doing business as

Broadway Pharmacy

Practice address

2790 Broadway Ave
North Bend, OR 97459-2216

Phone

(541) 449-9190

NPI assigned

Nov 3, 2021

Organization subpart

Yes

Parent organization

BEACON HEALTH CARE SOLUTIONS INCORPORATEDAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Thomas Hibbard, PHARMDNPI 1871960716

Title

President

Phone

(541) 449-9190

Specialties & licenses 1

Addresses

Other names 1

• Broadway Pharmacy Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Beacon Health Care Solutions Incorporated2 organizations share this tax ID, including this one

Part of

Beacon Health Care Solutions Incorporated

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Beacon Health Care Solutions Incorporated

  dba Broadway Pharmacy

  • Pharmacy
  • North Bend, OR
  • NPI 1598302119
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Beacon Health Care Solutions Incorporated

  dba Broadway Pharmacy

  • Pharmacy
  • North Bend, OR
  • NPI 1598302119
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Hibbard, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Portland, OR
  • NPI 1871960716
  NPD Authorized official
• Priyal Patel

  • Pharmacist
  • North Bend, OR
  • NPI 1255701876
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1114682382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 BROADWAY AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592216",
            "telephone_number": "541-449-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 BROADWAY AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592216",
            "telephone_number": "541-449-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH CARE SOLUTIONS INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON HEALTH CARE SOLUTIONS INCORPORATED",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "HIBBARD",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-449-9190",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Baycrest Estates, LLC (Baycrest Health & Rehabilitation)
• Beacon Health Care Solutions Incorporated (Broadway Pharmacy)
• Tamara Beardsley
• Julie Ann Bearup Wyatt
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• Susann Beaulieu

• Clinical Medical Laboratory in North Bend, OR
• Providers in North Bend, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.