Provider Demographics
NPI:1689810822
Name:HOUCHENS NORRTH FOODS LLC
Entity Type:Organization
Organization Name:HOUCHENS NORRTH FOODS LLC
Other - Org Name:BUEHLER'S PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT MANAGER PHARMACY OPERATIO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-471-7575
Mailing Address - Street 1:1550 VANN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-3359
Mailing Address - Country:US
Mailing Address - Phone:812-471-7575
Mailing Address - Fax:812-469-7438
Practice Address - Street 1:1550 VANN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-3359
Practice Address - Country:US
Practice Address - Phone:812-471-7575
Practice Address - Fax:812-469-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL540138133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1168390003Medicare NSC