Healthcare Provider Details

I. General information

NPI: 1811096068
Provider Name (Legal Business Name): BUTLERS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E MAIN ST
CLINTON NC
28328-4031
US

IV. Provider business mailing address

PO BOX 126
CLINTON NC
28329-0126
US

V. Phone/Fax

Practice location:
  • Phone: 910-592-2111
  • Fax: 910-592-8097
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number03729
License Number StateNC

VIII. Authorized Official

Name: JACK WATERS
Title or Position: PRES
Credential:
Phone: 910-592-2111