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General NPI Number Information
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NPI Number | 1043260375
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Entity Type | Individual
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Provider Name | ROBERT P BUSAKOWSKI RPH
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 128 W GENESEE ST
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City | IRON RIVER
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State | MI
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Zip | 49935-1437
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Country | US
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Telephone | 906-265-2312
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Fax | 906-265-5608
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Provider Business Mailing Address
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Address Line | 124 W ROSS ST
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City | IRON RIVER
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State | MI
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Zip | 49935-1749
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Country | US
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Telephone | 906-265-9616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302022940
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License Number State | MI
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