# BUTLER LONG TERM CARE SOLUTIONS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609327089
- **Authorized official:** ROBERT JOHNNY BAZEMORE PHARM D (RPH/OWNER)
- **Authorized official phone:** (478) 862-5655

## Contact information

- **Practice address:** 10 B NORTH POPLAR ST, BUTLER, GA 31006
- **Practice address phone:** (478) 862-5655
- **Practice address fax:** (478) 862-2811
- **Mailing address:** PO BOX 546, BUTLER, GA 31006-0546
- **Mailing address phone:** (478) 862-5655
- **Mailing address fax:** (478) 862-2811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHRE010310 | GA | Yes |

## Other

- **Enumeration date:** 10/20/2016
- **Last updated:** 10/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000793295A,B,C | — | GA |
| 01 | — | FLU372 | MEDICARE FLU SUBMITTER ID | GA |