Provider Demographics
NPI:1760527014
Name:BUCHELE DRUG
Entity Type:Organization
Organization Name:BUCHELE DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUCHELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-854-3861
Mailing Address - Street 1:201 CAULMET AVE
Mailing Address - Street 2:
Mailing Address - City:DESMET
Mailing Address - State:SD
Mailing Address - Zip Code:57231
Mailing Address - Country:US
Mailing Address - Phone:605-854-3861
Mailing Address - Fax:
Practice Address - Street 1:201 CAULMET AVE
Practice Address - Street 2:
Practice Address - City:DESMET
Practice Address - State:SD
Practice Address - Zip Code:57231
Practice Address - Country:US
Practice Address - Phone:605-854-3861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD40001000109846333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8501250Medicaid