Provider Demographics
NPI:1538591375
Name:BUCKEYE PHARMACY
Entity type:Organization
Organization Name:BUCKEYE PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ISSIFU
Authorized Official - Middle Name:
Authorized Official - Last Name:TENII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-391-7441
Mailing Address - Street 1:3900 AMERICAN DR STE 101B
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6188
Mailing Address - Country:US
Mailing Address - Phone:214-391-7441
Mailing Address - Fax:214-391-7443
Practice Address - Street 1:3900 AMERICAN DR STE 101B
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6188
Practice Address - Country:US
Practice Address - Phone:214-391-7441
Practice Address - Fax:214-391-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-04
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146899Medicaid
2144319OtherPK