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General NPI Number Information
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NPI Number | 1235171893
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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 | 06/11/2006
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 730 SOM CENTER RD STE 100
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143-2350
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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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Provider Business Mailing Address
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Address Line | 730 SOM CENTER RD STE 100
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143-2350
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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 | MANAGER
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Name | DAVID BRAGINSKY
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Credential |
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Telephone | 440-605-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 021395150
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License Number State | OH
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