Active NPI
Buderer Drug Company Inc
- Community/Retail Pharmacy
- Sandusky, OH
National Provider Identifier
1013067107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- BUDERER DRUG COMPANY INC
- Practice address
- 633 Hancock St
Sandusky, OH 44870-3603 - Phone
- (419) 627-2800
- Fax
- (419) 626-0494
- NPI assigned
- Jan 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew J Buderer, R.PH.
- Title
- Vice President
- Phone
- (419) 627-2800
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X |
Addresses
Primary practice location
633 Hancock St
Sandusky, OH 44870-3603
Mailing address
633 Hancock St
Sandusky, OH 44870-3603
Phone (419) 627-2800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0221106900 | Other | OH | OHIO BOARD OF PHARMACY LICENSE TDDD |
| 2076521 | Other | PK | |
| 3098740 | Medicaid | OH | |
| 3666801 | Other | OH | NCPDP |
| OH1830 | Other | KY | KENTUCKY BOARD OF PHARMACY |
Other names 1
- Buderer Drug Company, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210608000384 | OH | Part B Supplier - Pharmacy | 7618377094 |
1 other NPI on this enrollment Practice locations: Avon, OH; Sandusky, OH |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2210268 | Buderer Drug Co | Certificate of waiver | Jan 19, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Buderer Drug Co
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialty Pharmacy
- Perrysburg, OH
- NPI 1174673362
-
- Community/Retail Pharmacy
- Avon, OH
- NPI 1750677944
Locations
633 Hancock St
Sandusky, OH 44870
Phone (419) 627-2800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686182400000",
"number": "1013067107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 HANCOCK ST",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448703603",
"telephone_number": "419-627-2800",
"fax_number": "419-626-0494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 HANCOCK ST",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448703603",
"telephone_number": "419-627-2800",
"fax_number": "419-626-0494"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUDERER DRUG COMPANY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-11",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A",
"authorized_official_last_name": "BUDERER",
"authorized_official_first_name": "MATTHEW",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "419-627-2800",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BOARD OF PHARMACY LICENSE TDDD",
"identifier": "0221106900",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2076521",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3098740",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3666801",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY BOARD OF PHARMACY",
"identifier": "OH1830",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Buderer Drug Company, Inc.",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Buderer Drug Company, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sandusky, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.