=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760476501
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUSCHS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2005
-----------------------------------------------------
Last Update Date | 01/13/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2020 GREEN RD
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48105-2553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-994-7246
-----------------------------------------------------
Fax | 734-994-0638
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2020 GREEN RD
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48105-2553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-994-7246
-----------------------------------------------------
Fax | 734-994-0638
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PHARMACY SALES
-----------------------------------------------------
Name | MRS. RACHELLE L ROUSH
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 734-994-7246
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 5301007282
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------