NPIMap

Organization Active NPI

Buckley Brands LLC

  • Community/Retail Pharmacy
  • Detroit, MI
National Provider Identifier
1376842765
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009538 Issued in MI
Legal business name
BUCKLEY BRANDS LLC
Practice address
18021 Conant St
Detroit, MI 48234
Phone
(313) 368-1000
Fax
(313) 368-1068
NPI assigned
Mar 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Cole, PHARMDNPI 1811029127
Title
Managing Member
Phone
(313) 971-5030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009538 MI Primary

Addresses

Primary practice location

18021 Conant St
Detroit, MI 48234

Mailing address

18021 Conant St
Detroit, MI 48234
Phone (313) 368-1000

Other identifiers 2

IdentifierTypeStateIssuer
2365600MedicaidMI
2375283OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Buckley's Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

18021 Conant St
Detroit, MI 48234
Phone (313) 368-1000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1376842765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18021 CONANT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48234",
            "telephone_number": "313-368-1000",
            "fax_number": "313-368-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18021 CONANT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48234",
            "telephone_number": "313-368-1000",
            "fax_number": "313-368-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKLEY BRANDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "313-971-5030",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365600",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2375283",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckley's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.