Healthcare Provider Details

I. General information

NPI: 1235071911
Provider Name (Legal Business Name): CAMERON LEE BUSCHKOETTER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SAGAMORE PKWY W
WEST LAFAYETTE IN
47906-1446
US

IV. Provider business mailing address

4749 PEEBLESHIRE LN
LAFAYETTE IN
47909-9347
US

V. Phone/Fax

Practice location:
  • Phone: 765-497-2300
  • Fax:
Mailing address:
  • Phone: 812-639-9679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26031808A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: