MEDICARE: MRS. JACQUELINE BUCHSBAUM R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS26598	FL

General Provider Information

NPI Number	:	1093099442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACQUELINE BUCHSBAUM R.PH.

Provider Business Mailing Address
First Line	:	12840 MARSH POINTE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33418-6972
Country	:	US
Telephone Number	:	561-775-2619
Fax Number	:

Provider Business Practice Location Address
First Line	:	6297 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4000
Country	:	US
Telephone Number	:	561-627-2505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2011
Last Update Date	:	10/04/2011

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