Provider Demographics
NPI:1376843169
Name:BUTLER HEALTHCARE PROVIDERS
Entity Type:Organization
Organization Name:BUTLER HEALTHCARE PROVIDERS
Other - Org Name:BHS RETAIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-284-4879
Mailing Address - Street 1:1 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4670
Mailing Address - Country:US
Mailing Address - Phone:724-284-6363
Mailing Address - Fax:724-284-6344
Practice Address - Street 1:1 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4670
Practice Address - Country:US
Practice Address - Phone:724-284-6363
Practice Address - Fax:724-284-6344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4820343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2125128OtherPK
PA1007731600035Medicaid