MEDICARE: BUCKYS PHARMACY INC

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	PS38614	FL

General Provider Information

NPI Number	:	1124231444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUCKYS PHARMACY INC

Provider Business Mailing Address
First Line	:	1519 SE 13TH ST
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-7137
Country	:	US
Telephone Number	:	954-592-5406
Fax Number	:	954-772-0614

Provider Business Practice Location Address
First Line	:	6000 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2226
Country	:	US
Telephone Number	:	954-592-5406
Fax Number	:	954-772-0614

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EARL WILLIAM SAWISCH
Credential	:	RPH
Telephone Number	:	954-592-5406

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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