Provider Demographics
NPI:1538205570
Name:BUSCHAK, SALLY ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:ANN
Last Name:BUSCHAK
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 1:1910 COCHRAN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1203
Mailing Address - Country:US
Mailing Address - Phone:412-561-6532
Mailing Address - Fax:
Practice Address - Street 1:1910 COCHRAN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1203
Practice Address - Country:US
Practice Address - Phone:412-561-6532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030405L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP030405LOtherPHARMICIST