Provider Demographics
NPI:1255529475
Name:BUDZ, JOHN P (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:BUDZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LORD TER N
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4946
Mailing Address - Country:US
Mailing Address - Phone:413-592-2848
Mailing Address - Fax:
Practice Address - Street 1:32 LORD TER N
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-4946
Practice Address - Country:US
Practice Address - Phone:413-592-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist