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General NPI Number Information
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NPI Number | 1093297012
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Entity Type | Individual
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Provider Name | MATTHEW ALBERT
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Gender | Male
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 209 W 2ND ST
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City | MINNEAPOLIS
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State | KS
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Zip | 67467-2311
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Country | US
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Telephone | 785-392-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 N. BUCKEYE
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City | ABILENE
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State | KS
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Zip | 67410
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Country | US
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Telephone | 785-263-3770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-106218
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License Number State | KS
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