Healthcare Provider Details

I. General information

NPI: 1669705174
Provider Name (Legal Business Name): CURTIS WAYNE BUTTS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 SUNSET BLVD N
SUNSET BEACH NC
28468-4262
US

IV. Provider business mailing address

852 SUNSET BLVD N
SUNSET BEACH NC
28468-4262
US

V. Phone/Fax

Practice location:
  • Phone: 910-579-4503
  • Fax: 910-579-1269
Mailing address:
  • Phone: 910-579-4503
  • Fax: 910-579-1269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17431
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: