Provider Demographics
NPI:1881366433
Name:BUTTRICK, VINCE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VINCE
Middle Name:
Last Name:BUTTRICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4589
Mailing Address - Country:US
Mailing Address - Phone:330-421-9199
Mailing Address - Fax:
Practice Address - Street 1:2720 SUNSET BOULEVARD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-936-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC139101835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care