Provider Demographics
NPI:1215199039
Name:BUSCH'S INC
Entity Type:Organization
Organization Name:BUSCH'S INC
Other - Org Name:BUSCH'S PHARMACY 1199
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CHIEF FINANCIAL OFF
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRUPSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-214-8356
Mailing Address - Street 1:565 E. MICHIGAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1588
Mailing Address - Country:US
Mailing Address - Phone:734-214-8321
Mailing Address - Fax:734-214-8322
Practice Address - Street 1:33300 W. 14 MILE RD.
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3572
Practice Address - Country:US
Practice Address - Phone:248-855-1745
Practice Address - Fax:248-855-1912
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUSCH'S INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008881332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5301008881OtherPHARMACY LICENSE
MI5301008881OtherPHARMACY LICENSE
MIFB0876978OtherDEA NUMBER