Provider Demographics
NPI:1063523520
Name:BUCHANAN, DIANE M (RPH)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E 7TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-2535
Mailing Address - Country:US
Mailing Address - Phone:260-925-8000
Mailing Address - Fax:
Practice Address - Street 1:1314 E 7TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2535
Practice Address - Country:US
Practice Address - Phone:260-925-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014471A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist