Active NPI
Butler Drug Store Inc
- Durable Medical Equipment & Medical Supplies
- Portageville, MO
National Provider Identifier
1285889014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- BUTLER DRUG STORE INC
- Practice address
- 222 E Main St
Portageville, MO 63873-1614 - Phone
- (573) 379-5460
- Fax
- (573) 379-5459
- NPI assigned
- Nov 20, 2008
- Organization subpart
- Yes
- Parent organization
- BUTLER DRUG STORE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Donald Rone, PHARMD
- Title
- Owner
- Phone
- 57337795460
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
222 E Main St
Portageville, MO 63873-1614
Mailing address
222 E Main St
Portageville, MO 63873-1614
Phone (573) 379-5460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620201400 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171120001988 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 0244358562 | Practice locations: Portageville, MO |
National Provider Directory
National Provider Directory- Part of
- Butler Drugstore Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1227139200000",
"number": "1285889014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 E MAIN ST",
"city": "PORTAGEVILLE",
"state": "MO",
"postal_code": "638731614",
"telephone_number": "573-379-5460",
"fax_number": "573-379-5459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 E MAIN ST",
"city": "PORTAGEVILLE",
"state": "MO",
"postal_code": "638731614",
"telephone_number": "573-379-5460",
"fax_number": "573-379-5459"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUTLER DRUG STORE INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BUTLER DRUG STORE INC",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A",
"authorized_official_last_name": "RONE",
"authorized_official_first_name": "DONALD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "57337795460",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620201400",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portageville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.