MEDICARE: CHAD MICHAEL BUHR RPH

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	26018923	IN

General Provider Information

NPI Number	:	1376149518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD MICHAEL BUHR RPH

Provider Business Mailing Address
First Line	:	16304 CANYON RUN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-9090
Country	:	US
Telephone Number	:	260-223-2685
Fax Number	:	401-216-3129

Provider Business Practice Location Address
First Line	:	7330 LIMA RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46818-1130
Country	:	US
Telephone Number	:	260-223-2685
Fax Number	:

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

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	12/10/2020

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Directions to “ CHAD MICHAEL BUHR RPH” Practice Location

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