Healthcare Provider Details

I. General information

NPI: 1023301926
Provider Name (Legal Business Name): NATHANIEL DOUGLAS BUCHER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 EASTPOINT PKWY
LOUISVILLE KY
40223-4123
US

IV. Provider business mailing address

11401 BLUEGRASS PKWY
LOUISVILLE KY
40299-4123
US

V. Phone/Fax

Practice location:
  • Phone: 866-501-3997
  • Fax: 866-567-3643
Mailing address:
  • Phone: 866-501-3997
  • Fax: 866-567-3643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03331284
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number016372
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: