Michael J Budde
Individual provider Active NPI Pharmacist · Columbia, IL
NPI 1770852154 · NPPES record last updated Dec 14, 2011
Key facts
- NPI
- 1770852154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051028719 (IL)
- Practice address
- 134 S Main St
Columbia, IL 62236-2306 - Phone
- (618) 281-5135
- Fax
- (618) 281-4181
- NPI assigned
- Dec 14, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051028719 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Economy Pharmacy, Inc. | Past | Accepting new patients | |
| Vasquez Pharmacy Inc | Pharmacist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051028719 | IL | Yes |
Addresses
Primary practice location
134 S Main St
Columbia, IL 62236-2306
Mailing address
134 S Main St
Columbia, IL 62236-2306
Phone (618) 281-5135
Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2011. 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.