Provider Demographics
NPI:1679753511
Name:BUTLER, JOHN PATRICK (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PATRICK
Last Name:BUTLER
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 1:156 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-2946
Mailing Address - Country:US
Mailing Address - Phone:570-639-2512
Mailing Address - Fax:
Practice Address - Street 1:5775 ALLENTOWN BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4049
Practice Address - Country:US
Practice Address - Phone:717-810-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037319L1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric