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General NPI Number Information
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NPI Number | 1306906219
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Entity Type | Organization
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Legal Business Name | BERTHA BUCK DBA BUCKS HOMECARE SERVICES
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2199 ST. HWY Z
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City | BRAGGADOCIO
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State | MO
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Zip | 63826-0130
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Country | US
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Telephone | 573-757-6257
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Fax | 573-757-6257
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | BRAGGADOCIO
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State | MO
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Zip | 63826-0130
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Country | US
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Telephone | 573-757-6257
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Fax | 573-757-6257
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Authorized Official
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Title or Position | C.E.O.
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Name | MRS. BERTHA BUCK
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Credential |
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Telephone | 573-757-6257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MO
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