Healthcare Provider Details

I. General information

NPI: 1487598454
Provider Name (Legal Business Name): SAMUEL BUSCHE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20490 MURPHY RD
BEND OR
97702-3086
US

IV. Provider business mailing address

20490 MURPHY RD
BEND OR
97702-3086
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0020198
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: