Healthcare Provider Details

I. General information

NPI: 1477570935
Provider Name (Legal Business Name): MATTHEW EVERETT MATTHEWS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 MOUNT ROYAL BLVD
PITTSBURGH PA
15223-1046
US

IV. Provider business mailing address

70 COLONY OAKS DR
PITTSBURGH PA
15209-1240
US

V. Phone/Fax

Practice location:
  • Phone: 412-486-5200
  • Fax: 412-486-3335
Mailing address:
  • Phone: 412-821-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPO38344L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: