Healthcare Provider Details

I. General information

NPI: 1699075069
Provider Name (Legal Business Name): SHAWN BUTLER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 UINTAH GARDENS
COLORADO SPRINGS CO
80904
US

IV. Provider business mailing address

1750 UINTAH GARDENS
COLORADO SPRINGS CO
80904
US

V. Phone/Fax

Practice location:
  • Phone: 719-636-5046
  • Fax: 719-633-9140
Mailing address:
  • Phone: 719-636-5046
  • Fax: 719-633-9140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18640
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11994
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: