Organization
MICHAEL H BUTTS
Active
Other names
MIKES GIBSON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H BUTTS RPH (OWNER)
(806) 874-3554
Entity
Organization
Contact information
Practice address
501 WEST 2ND BOX 1030, CLARENDON, TX 79226-1030
(806) 874-3554
(806) 874-9287
Mailing address
PO BOX 1030, CLARENDON, TX 79226-1030
(806) 874-3554
(806) 874-9287
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10254
TX
3336L0003X
Long Term Care Pharmacy
10254
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142479
—
TX
01
—
4550554
NCPDP
—
Enumeration date
02/21/2007
Last updated
07/02/2008
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