Provider Demographics
NPI:1326574047
Name:BUTTON, AMBER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:BUTTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LLANO ST
Mailing Address - Street 2:
Mailing Address - City:AZTEC
Mailing Address - State:NM
Mailing Address - Zip Code:87410-2172
Mailing Address - Country:US
Mailing Address - Phone:505-334-6411
Mailing Address - Fax:505-334-7187
Practice Address - Street 1:100 LLANO ST
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-2172
Practice Address - Country:US
Practice Address - Phone:505-334-6411
Practice Address - Fax:505-334-7187
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008085183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1262850002Medicare UPIN
NM061499Medicare PIN