Provider Demographics
NPI:1104125178
Name:BUENAFE, CONCEPCION A (PHARMACIST)
Entity type:Individual
Prefix:MISS
First Name:CONCEPCION
Middle Name:A
Last Name:BUENAFE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11917 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3030
Mailing Address - Country:US
Mailing Address - Phone:410-833-0183
Mailing Address - Fax:410-517-1094
Practice Address - Street 1:11917 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-3030
Practice Address - Country:US
Practice Address - Phone:410-833-0183
Practice Address - Fax:410-517-1094
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist