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General NPI Number Information
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NPI Number | 1447263512
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Entity Type | Organization
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Legal Business Name | BUTASH PHARMACY
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 319 GEORGE ST
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City | THROOP
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State | PA
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Zip | 18512-1234
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Country | US
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Telephone | 570-489-2331
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Fax | 570-489-4791
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Provider Business Mailing Address
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Address Line | 319 GEORGE ST
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City | THROOP
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State | PA
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Zip | 18512-1234
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Country | US
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Telephone | 570-489-2331
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Fax | 570-489-4791
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL JOSEPH BUTASH
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Credential | PHARMACIST
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Telephone | 570-489-2331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP410314L
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License Number State | PA
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