Provider Demographics
NPI:1033259197
Name:V E BUTLER AND ASSOCIATES PC
Entity Type:Organization
Organization Name:V E BUTLER AND ASSOCIATES PC
Other - Org Name:COMMUNITYCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:260-458-9800
Mailing Address - Street 1:2700 S. LAFAYETTE ST
Mailing Address - Street 2:COMMUNITYCARE PHARMACY
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46806-1100
Mailing Address - Country:US
Mailing Address - Phone:260-458-9800
Mailing Address - Fax:
Practice Address - Street 1:2700 S. LAFAYETTE ST
Practice Address - Street 2:COMMUNITYCARE PHARMACY
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46806-1100
Practice Address - Country:US
Practice Address - Phone:260-458-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN260177701835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1529657OtherNABP NUMBER