Healthcare Provider Details

I. General information

NPI: 1164261699
Provider Name (Legal Business Name): MATT DUBIL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 E STATE ST
ATHENS OH
45701-2117
US

IV. Provider business mailing address

280 E STATE ST STE 102
ATHENS OH
45701-1871
US

V. Phone/Fax

Practice location:
  • Phone: 740-566-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: