Healthcare Provider Details

I. General information

NPI: 1124006986
Provider Name (Legal Business Name): MATTHEWS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NORTHEAST BLVD
CLINTON NC
28328-2434
US

IV. Provider business mailing address

408 NORTHEAST BLVD
CLINTON NC
28328-2434
US

V. Phone/Fax

Practice location:
  • Phone: 910-592-3121
  • Fax: 910-592-5111
Mailing address:
  • Phone: 910-592-3121
  • Fax: 910-592-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number003350
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES SPENCER MATTHEWS
Title or Position: OWNER CEO
Credential: RPH
Phone: 910-592-3121