Buckleys Pharmacy of Warren LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010625 Issued in MI

Legal business name

BUCKLEYS PHARMACY OF WARREN LLC

Doing business as

Buckley's Pharmacy #105

Practice address

29200 Ryan Rd
Warren, MI 48092-4242

Phone

(586) 558-8787

Fax

(586) 558-8793

NPI assigned

Feb 3, 2015

Organization subpart

No

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

Authorized official

Name

Anthony Cole, PHARMDMPHMBAMS

Title

Director of Clinical Services

Phone

(586) 558-8787

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Buckley's Pharmacy #105 Doing business as

Locations

Practitioners 1

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

• Razur Rahman, RPH

  • Pharmacist
  • Warren, MI
  • NPI 1043738552
  NPD (past)

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1861882599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29200 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924242",
            "telephone_number": "586-558-8787",
            "fax_number": "586-558-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29200 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924242",
            "telephone_number": "586-558-8787",
            "fax_number": "586-558-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKLEYS PHARMACY OF WARREN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "586-558-8787",
        "authorized_official_credential": "PHARMDMPHMBAMS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150063",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckley's Pharmacy #105",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bubble Gum Kids Dentistry
• Steven D Buchan, MD
• Pradeep Buchireddygari
• Miranda Eileen Buchowski, PHARMD
• Amelia Lakim Buckley
• Lynn Renee Buero, PHARMD
• Micheal Buggia, M.D.
• Kiajuanna Bullock
• Saad Buni
• Maria Burch, REGISTERED PHARMACIS

• Community/Retail Pharmacy in Warren, MI
• Providers in Warren, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.