Provider Demographics
NPI:1548545981
Name:BUCK, SAMANTHA WHITNEY (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:WHITNEY
Last Name:BUCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 32ND AVE S STE 101B
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6509
Mailing Address - Country:US
Mailing Address - Phone:701-757-1552
Mailing Address - Fax:701-757-1542
Practice Address - Street 1:2424 32ND AVE S STE 101B
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6509
Practice Address - Country:US
Practice Address - Phone:701-757-1552
Practice Address - Fax:701-757-1542
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist