Provider Demographics
NPI:1144314550
Name:BUTLER PHARMACY INC
Entity type:Organization
Organization Name:BUTLER PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-892-4488
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:PT PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-0627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4329
Practice Address - Country:US
Practice Address - Phone:732-892-4488
Practice Address - Fax:732-892-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS002301003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4239709Medicaid
2054121OtherPK
0255100001Medicare NSC