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General NPI Number Information
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NPI Number | 1750677944
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Entity Type | Organization
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Legal Business Name | BUDERER DRUG COMPANY INC
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Dates
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Enumeration Date | 06/26/2011
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 38530 CHESTER RD SUITE 400
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City | AVON
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State | OH
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Zip | 44011-4047
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Country | US
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Telephone | 440-934-3100
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Fax | 440-934-3103
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Provider Business Mailing Address
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Address Line | 38530 CHESTER RD SUITE 400
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City | AVON
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State | OH
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Zip | 44011-4047
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Country | US
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Telephone | 440-934-3100
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Fax | 440-934-3103
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MATTHEW J BUDERER
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Credential | R.PH.
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Telephone | 419-873-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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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 | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | SP022133300
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License Number State | OH
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