Provider Demographics
NPI:1578657888
Name:BUECHLER PHARMACY INC
Entity Type:Organization
Organization Name:BUECHLER PHARMACY INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUECHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-996-7751
Mailing Address - Street 1:1007 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-1351
Mailing Address - Country:US
Mailing Address - Phone:605-996-7751
Mailing Address - Fax:605-996-4196
Practice Address - Street 1:1007 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-1351
Practice Address - Country:US
Practice Address - Phone:605-996-7751
Practice Address - Fax:605-996-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
SD10018013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD95667440Medicaid
SD8504110Medicaid
SD9167090Medicaid
4300478OtherNCPDP PROVIDER IDENTIFICATION NUMBER
4300478OtherNCPDP PROVIDER IDENTIFICATION NUMBER
SD8504110Medicaid