STAN BUCZKO RPH (NPI# 1780756569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780756569 |
| Entity Type | Organization |
| Organization Name | STAN BUCZKO RPH |
| Other Organization Name | MEDICINE SHOPPE |
| Practice Address |
490 N Main St Canton IL 61520-1828 |
| Practice Telephone | 3096471717 |
| Practice Fax Number | 3096471734 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | STAN BUCZKO (OWNER PHARMACIST) |
| Authorized Official Telephone | 3096471717 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA # | AT2811823 | 01 |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1448857 | 01 |
| Other Name | Type Code |
|---|---|
| MEDICINE SHOPPE | Doing Business As Name - Organization |
| Street Address |
490 N MAIN ST |
| City | CANTON |
| State | IL |
| Zip Code | 61520-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| Find all providers in zip 61520 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992367767 | Canton Family Pharmacy | Pharmacy | 145 N Haggerty Rd, Canton, MI 48187-3901 | 2019-07-02 |
| 1447734496 | Integrated Health Pharmacy LLC | Pharmacy | 49650 Cherry Hill Rd., Canton, MI 48187 | 2018-09-16 |
| 1497236533 | Discount Drug Mart Inc | Pharmacy | 2710 Easton St Ne Ste A, Canton, OH 44721-2691 | 2018-08-27 |
| 1356838890 | Hickory Drugs | Pharmacy | 6679 Hickory Flat Hwy, Canton, GA 30115-9225 | 2018-04-19 |
| 1376054833 | Cherry Hill Village Pharmacy LLC | Pharmacy | 50429 Independence St, Canton, MI 48188 | 2017-10-23 |
| 1932494473 | Kat International Group Inc | Pharmacy | 1750 Marietta Hwy Ste 260, Canton, GA 30114-8388 | 2011-06-13 |
| 1386941326 | Niemann Foods Inc | Pharmacy | 1805 Elm St, Canton, MO 63435-1685 | 2011-02-25 |
| 1285948588 | Jay Krishna LLC | Pharmacy | 7309 N Lilley Rd, Canton, MI 48187-2457 | 2010-07-29 |
| 1003129982 | Canton Specialty Pharmacy LLC | Pharmacy | 305 N Lilley Rd, Canton, MI 48187-3908 | 2010-07-20 |
| 1992948574 | Healthplus Pharmacy, Inc. | Pharmacy | 49650 Cherry Hill Rd Ste 140, Canton, MI 48187-4857 | 2009-04-13 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.