D Jack Buroker, R PH
Individual provider Active NPI Pharmacist · Kenton, OH
NPI 1154539336 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154539336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03-1-07629 (OH)
- Practice address
- 981 E Columbus St
Kenton, OH 43326-1650 - Phone
- (419) 675-2705
- Fax
- (419) 674-4098
- NPI assigned
- May 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03-1-07629 | OH | Yes |
Addresses
Primary practice location
981 E Columbus St
Kenton, OH 43326-1650
Mailing address
402 E Franklin St
Kenton, OH 43326-2011
Phone (419) 675-2575
Other providers in Kenton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.