Healthcare Provider Details

I. General information

NPI: 1427117217
Provider Name (Legal Business Name): JEFFERY P. BUTCHER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W PIKE ST
MORROW OH
45152-1107
US

IV. Provider business mailing address

4929 RIDGEVIEW DR
COVINGTON KY
41015-2011
US

V. Phone/Fax

Practice location:
  • Phone: 513-899-4074
  • Fax: 513-899-3783
Mailing address:
  • Phone: 513-265-9016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-19022
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: