Healthcare Provider Details

I. General information

NPI: 1982693628
Provider Name (Legal Business Name): DAVID PAUL BUTLER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/16/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 UNION ST
AUBURN ME
04210-5475
US

IV. Provider business mailing address

22 BROWN ST
LEWISTON ME
04240-5714
US

V. Phone/Fax

Practice location:
  • Phone: 207-753-0102
  • Fax: 207-753-0503
Mailing address:
  • Phone: 207-240-1716
  • Fax: 207-753-0503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4043
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number4043
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: