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General NPI Number Information
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NPI Number | 1114265170
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Entity Type | Individual
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Provider Name | MATTHEW GARVIN PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2013
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Last Update Date | 01/27/2013
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Provider Practice Location Address
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Address Line | 1289 DEMING WAY
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City | MADISON
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State | WI
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Zip | 53717-2007
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Country | US
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Telephone | 800-558-7046
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Fax |
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Provider Business Mailing Address
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Address Line | 832 E GORHAM ST
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City | MADISON
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State | WI
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Zip | 53703-1562
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Country | US
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Telephone |
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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 | 15384-40
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH3342
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S019168
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License Number State | AZ
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