MEDICARE: MATVALS CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RI020106	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437210820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATVALS CORP

Provider Business Mailing Address
First Line	:	2260 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-1462
Country	:	US
Telephone Number	:	201-432-5205
Fax Number	:	201-432-2578

Provider Business Practice Location Address
First Line	:	2260 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-1462
Country	:	US
Telephone Number	:	201-432-5205
Fax Number	:	201-432-2578

Authorized Official
Title or Position	:	R.PH IN CHARGE
Name	:	MR. MOHAN MATHEW
Credential	:	PHARMACIST
Telephone Number	:	201-432-5205

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	05/14/2010

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Directions to “MATVALS CORP ” Practice Location

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