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General NPI Number Information
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NPI Number | 1184569030
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Entity Type | Organization
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Legal Business Name | ST. MATTHEWS PHARMACY LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 161 SEARS AVE 278
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-406-2109
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Fax | 844-601-3444
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Provider Business Mailing Address
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Address Line | 9500 ORMSBY STATION RD STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40223-4076
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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 | PHARMACY ADMINISTRATIVE SPECIALIST
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Name | FARA TIPPIT
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Credential |
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Telephone | 502-760-0089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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