MEDICARE: MRS. SALLY ANN BUSCHAK 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	RP030405L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP030405L	OTHER	PA	PHARMICIST

General Provider Information

NPI Number	:	1538205570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SALLY ANN BUSCHAK RPH

Provider Business Mailing Address
First Line	:	1910 COCHRAN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-1203
Country	:	US
Telephone Number	:	412-561-6532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 COCHRAN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-1203
Country	:	US
Telephone Number	:	412-561-6532
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/12/2007

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