Provider Demographics
NPI:1356485684
Name:BUERKLE DRUG MANAGEMENT LLC
Entity Type:Organization
Organization Name:BUERKLE DRUG MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/PHARMACIST IN CHAR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:890-673-1311
Mailing Address - Street 1:202 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-4355
Mailing Address - Country:US
Mailing Address - Phone:870-673-1311
Mailing Address - Fax:870-673-3784
Practice Address - Street 1:202 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-4355
Practice Address - Country:US
Practice Address - Phone:870-673-1311
Practice Address - Fax:870-673-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
ARAR4127743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100274407Medicaid
1994247OtherPK