=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144314550
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUTLER PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 09/16/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2301 BRIDGE AVE
-----------------------------------------------------
City | POINT PLEASANT BORO
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08742-4329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-892-4488
-----------------------------------------------------
Fax | 732-892-8014
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 627
-----------------------------------------------------
City | PT PLEASANT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08742-0627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP
-----------------------------------------------------
Name | TRACY STEEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-892-4488
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 28RS00230100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------