Provider Demographics
NPI:1659364487
Name:BUTT DRUGS, INC.
Entity Type:Organization
Organization Name:BUTT DRUGS, INC.
Other - Org Name:BUTT DRUGS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR/PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTT BECKORT
Authorized Official - Suffix:
Authorized Official - Credentials:BS MNGMT, CPHT
Authorized Official - Phone:812-738-3272
Mailing Address - Street 1:115 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-1105
Mailing Address - Country:US
Mailing Address - Phone:812-738-3272
Mailing Address - Fax:812-738-1406
Practice Address - Street 1:115 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-1105
Practice Address - Country:US
Practice Address - Phone:812-738-3272
Practice Address - Fax:812-738-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
IN60002453A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2024311OtherPK
IN100296830AMedicaid
IN100296830AMedicaid