=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376744995
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHERI MARIE BUSER RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 535 HILL ST
-----------------------------------------------------
City | DUBUQUE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52001-6678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-588-4033
-----------------------------------------------------
Fax | 563-588-4044
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20643 150TH ST
-----------------------------------------------------
City | MAQUOKETA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52060-8729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-672-3648
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 17614
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------