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NPI Code Detail

MEDICARE: MR. RYAN EUGENE BUTLER RPH

MEDICARE: MR. RYAN EUGENE BUTLER RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist2000163536MO

General Provider Information

NPI Number : 1790808061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN EUGENE BUTLER RPH
Provider Business Mailing Address
First Line : 5135 PATTERSON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-2441
Country : US
Telephone Number : 314-416-0101
Fax Number :
Provider Business Practice Location Address
First Line : 1275 N TRUMAN BLVD
Second Line :
City : FESTUS
State : MO
Zip : 63028-1176
Country : US
Telephone Number : 636-937-4686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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