{"npi":"1124063342","type":"NPI-2","status":"active","name":{"display":"Buckner Neighborhood Pharmacy INC","other":[],"organization_name":"BUCKNER NEIGHBORHOOD PHARMACY INC","authorised_official":"Samson Berhe"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"TX","license":"24990"}]},"addresses":[{"purpose":"LOCATION","street_1":"3535 N BUCKNER BLVD STE 106A","city":"DALLAS","state":"TX","postal_code":"752285633","country_code":"US","phone":"9724218228"},{"purpose":"MAILING","street_1":"3535 N BUCKNER BLVD STE 106A","city":"DALLAS","state":"TX","postal_code":"752285633","country_code":"US","phone":"2143213000","fax":"9724218228"}],"license":{"state":"TX","number":"24990"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"145667","state":"TX","issuer":null},{"type_code":"01","label":"Other","value":"2099183","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20231114000816","type_code":"12-A5","type_desc":"PART B SUPPLIER - PHARMACY","state":"TX","pac_id":"7810344835"},{"enrlmt_id":"O20240110004048","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"TX","pac_id":"7810344835"}]},"enumeration_date":"2006-06-19","last_updated":"2025-11-06","_meta":{"source":"NPPES","snapshot_date":"2025-11-06","doc_url":"https://findmynpi.com/api"}}