=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962577213
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUTTE THERAPY SYSTEMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2006
-----------------------------------------------------
Last Update Date | 02/10/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 598 GARDEN HWY SUITE 13
-----------------------------------------------------
City | YUBA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95991-6334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-671-5144
-----------------------------------------------------
Fax | 530-742-6892
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 598 GARDEN HWY SUITE 13
-----------------------------------------------------
City | YUBA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95991-6334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-671-5144
-----------------------------------------------------
Fax | 530-742-6892
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CRAIG MICHAEL MENGHINI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 530-671-5144
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 4522400001
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------