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General NPI Number Information
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NPI Number | 1164035689
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Entity Type | Organization
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Legal Business Name | ALLERGY BUTLER, LLC
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1611 12TH AVE RD STE A
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City | NAMPA
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State | ID
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Zip | 83686-6182
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Country | US
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Telephone | 844-426-9843
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Fax |
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Provider Business Mailing Address
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Address Line | 10701 S OZARKS DR
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-5693
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Country | US
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Telephone | 801-652-7666
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EDWARD LOOMIS
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Credential |
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Telephone | 844-426-9843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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