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General NPI Number Information
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NPI Number | 1497901789
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Entity Type | Organization
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Legal Business Name | MATHES PHARMACY INC.
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 1621 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-3339
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Country | US
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Telephone | 812-944-3612
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Fax | 812-941-7303
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Provider Business Mailing Address
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Address Line | 1621 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-3339
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Country | US
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Telephone | 812-944-3612
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Fax | 812-941-7303
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. JOE DONES
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Credential | RPH
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Telephone | 812-944-3612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 60002254A
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License Number State | IN
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