Healthcare Provider Details

I. General information

NPI: 1184007288
Provider Name (Legal Business Name): ANDREW BUECHNER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 HIGHWAY 7
HOPKINS MN
55305-4739
US

IV. Provider business mailing address

4645 PARK COMMONS DR APT 513
ST LOUIS PARK MN
55416-4171
US

V. Phone/Fax

Practice location:
  • Phone: 952-939-1917
  • Fax:
Mailing address:
  • Phone: 612-600-7196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number122320
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: