Provider Demographics
NPI:1639738438
Name:VAN AMBURG & BUSIEK MD'S, LLC
Entity Type:Organization
Organization Name:VAN AMBURG & BUSIEK MD'S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE (PIC)
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:314-205-6737
Mailing Address - Street 1:232 S WOODSMILL ROAD
Mailing Address - Street 2:SUITE 330 EAST
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017
Mailing Address - Country:US
Mailing Address - Phone:314-576-2490
Mailing Address - Fax:314-576-2378
Practice Address - Street 1:232 S WOODSMILL ROAD
Practice Address - Street 2:SUITE 330 EAST
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:314-205-6980
Practice Address - Fax:314-573-2398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAN AMBURG & BUSIEK MD'S, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy