Organization
JAMES BUTTS JR RPH
Active
Other names
ANGEL FIRE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BUTTS RPH (OWNER AND PHARMACIST IN CHARGE)
(505) 377-2269
Entity
Organization
Contact information
Practice address
3394 HIGHWAY 434, ANGEL FIRE, NM 87710
(505) 377-2269
(505) 377-6220
Mailing address
PO BOX E, ANGEL FIRE, NM 87710-1004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00001207
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3206403
OTHER ID NUMBER
—
Enumeration date
03/15/2007
Last updated
09/12/2007
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