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General NPI Number Information
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NPI Number | 1124063342
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Entity Type | Organization
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Legal Business Name | BUCKNER NEIGHBORHOOD PHARMACY INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 3535 N BUCKNER BLVD STE 106A
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City | DALLAS
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State | TX
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Zip | 75228-5633
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Country | US
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Telephone | 972-421-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 N BUCKNER BLVD STE 106A
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City | DALLAS
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State | TX
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Zip | 75228-5633
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Country | US
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Telephone | 214-321-3000
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Fax | 972-421-8228
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | SAMSON BERHE
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Credential |
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Telephone | 214-321-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 24990
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License Number State | TX
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