Healthcare Provider Details

I. General information

NPI: 1306108808
Provider Name (Legal Business Name): WAYNE MICHAEL BUEHLER R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR
LEBANON MO
65536-9215
US

IV. Provider business mailing address

PO BOX 1153 200 HOSPITAL DRIVE
LEBANON MO
65536-1153
US

V. Phone/Fax

Practice location:
  • Phone: 417-533-6770
  • Fax: 417-533-6777
Mailing address:
  • Phone: 417-533-6770
  • Fax: 417-533-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040227
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: