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Contact Information

BUFFALO PROFESSIONAL PHARMACY INC
308 W DALLAS ST
BUFFALO, MO65622-7635
 Phone: 417-345-6500
 Fax: 417-345-6565
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BUFFALO PROFESSIONAL PHARMACY INC

NPI # 1831294792
LBN Legal business name BUFFALO PROFESSIONAL PHARMACY INC
Authorized official AL NYBERG - (PRESIDENT AND CHIEF RPH)
Entity Organization
Organization subpart 1 No
Enumeration date 09/14/2006
Last updated 09/19/2025 - About 9 months ago
Identifiers
MO License # 005240
MO Medicaid 602895104
Other 2051305 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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