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General NPI Number Information
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NPI Number | 1124231444
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Entity Type | Organization
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Legal Business Name | BUCKYS PHARMACY INC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6000 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-2226
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Country | US
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Telephone | 954-592-5406
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Fax | 954-772-0614
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Provider Business Mailing Address
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Address Line | 1519 SE 13TH ST
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-7137
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Country | US
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Telephone | 954-592-5406
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Fax | 954-772-0614
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EARL WILLIAM SAWISCH
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Credential | RPH
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Telephone | 954-592-5406
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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 | PS38614
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License Number State | FL
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