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General NPI Number Information
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NPI Number | 1730851494
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Entity Type | Individual
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Provider Name | AUGUSTINE CONG BUI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 5020 GRAPE RD
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City | MISHAWAKA
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State | IN
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Zip | 46545
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Country | US
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Telephone | 574-273-3510
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Fax | 574-273-3565
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Provider Business Mailing Address
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Address Line | 5020 GRAPE RD
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City | MISHAWAKA
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State | IN
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Zip | 46545
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Country | US
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Telephone | 574-273-3510
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Fax | 574-273-3565
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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 | 5302413706
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 44427
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License Number State | TN
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