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General NPI Number Information
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NPI Number | 1194960450
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Entity Type | Organization
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Legal Business Name | BUCKHEAD PHARMACEUTICAL ASSOCIATION, INC.
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 1299 MCNAUGHTEN ROAD
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City | COLUMBUS
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State | OH
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Zip | 43213
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Country | US
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Telephone | 614-866-2120
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Fax | 614-866-2128
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Provider Business Mailing Address
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Address Line | 730 S.O.M. CENTER RD. SUITE 100
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143
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Country | US
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Telephone | 440-605-0303
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Fax | 440-605-1437
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL BOGACHEK
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Credential |
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Telephone | 404-261-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 02-1913350
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-1913350
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License Number State | OH
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