Healthcare Provider Details

I. General information

NPI: 1407780059
Provider Name (Legal Business Name): SAMUEL CHRISTIAN BUESKING PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N OAKLAND AVE
BOLIVAR MO
65613-3099
US

IV. Provider business mailing address

690 S WILEY WAY
SPRINGFIELD MO
65802-5905
US

V. Phone/Fax

Practice location:
  • Phone: 417-350-8163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026024866
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: