Healthcare Provider Details

I. General information

NPI: 1801325527
Provider Name (Legal Business Name): MATTHEW D RUPERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 SOLDANO BLVD
COLUMBUS OH
43228-1458
US

IV. Provider business mailing address

3600 SOLDANO BLVD
COLUMBUS OH
43228-1458
US

V. Phone/Fax

Practice location:
  • Phone: 614-274-8108
  • Fax: 614-274-3417
Mailing address:
  • Phone: 614-274-8108
  • Fax: 614-274-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03230544
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: