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General NPI Number Information
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NPI Number | 1154282267
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Entity Type | Individual
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Provider Name | ANDREY BUIE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1065 S FORTUNA BLVD
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City | FORTUNA
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State | CA
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Zip | 95540
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Country | US
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Telephone | 707-726-0377
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Fax |
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Provider Business Mailing Address
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Address Line | 75 DEL VISTA CIR
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City | SACRAMENTO
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State | CA
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Zip | 95823-5634
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Country | US
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Telephone | 916-596-8632
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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 | 91586
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License Number State | CA
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