MEDICARE: IV CARE OF SA. 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	25841	TX

General Provider Information

NPI Number	:	1306841432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IV CARE OF SA. INC

Provider Business Mailing Address
First Line	:	6428 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1511
Country	:	US
Telephone Number	:	210-256-8629
Fax Number	:	210-256-8199

Provider Business Practice Location Address
First Line	:	6428 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1511
Country	:	US
Telephone Number	:	210-256-8629
Fax Number	:	210-256-8199

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MICHAEL BUCHMEIER
Credential	:
Telephone Number	:	210-256-8629

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	06/16/2008

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