MEDICARE: DR. MATTHEW TEAGUE PHARM. D

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	03129677	OH

General Provider Information

NPI Number	:	1629679683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW TEAGUE PHARM. D

Provider Business Mailing Address
First Line	:	4790 PORTAGE ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7245
Country	:	US
Telephone Number	:	330-497-7352
Fax Number	:

Provider Business Practice Location Address
First Line	:	4790 PORTAGE ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7245
Country	:	US
Telephone Number	:	330-497-7352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	11/05/2020

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1679532345 — DR. HEATHER L ALCORN O.D
Practice Location Address:

4790 PORTAGE ST NW
NORTH CANTON, OH
44720-7245

Practice Phone: 330-497-8428
Practice Fax:

1124045323 — SAMS EAST INC
Practice Location Address:

4790 PORTAGE ST NW
NORTH CANTON, OH
44720-7245

Practice Phone: 330-497-7352
Practice Fax:

1821191453 — SAM'S CLUB OPTICAL
Practice Location Address:

4790 PORTAGE ST NW
NORTH CANTON, OH
44720-7245

Practice Phone: 330-497-5295
Practice Fax:

1104428721 — KIMBERLY ANNE RICHTERMAN RPH
Practice Location Address:

4790 PORTAGE ST NW
NORTH CANTON, OH
44720-7245

Practice Phone: 330-497-7352
Practice Fax:

1639533953 — MARY WILSON APN, NP
Practice Location Address:

7245 BOULEVARD 26
NORTH RICHLAND HILLS, TX
76180-8605

Practice Phone: 850-304-7986
Practice Fax:

Directions to “ DR. MATTHEW TEAGUE PHARM. D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.