Provider Demographics
NPI:1922131192
Name:BUGANSKI, JOSEPH ALAN I
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALAN
Last Name:BUGANSKI
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 LINSAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6127
Mailing Address - Country:US
Mailing Address - Phone:513-385-5231
Mailing Address - Fax:
Practice Address - Street 1:4990 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4851
Practice Address - Country:US
Practice Address - Phone:859-746-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012095183500000X
OH03-2-17917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist