MEDICARE: MATTHEW JOSEPH HARRISON

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	2009022348	MO

General Provider Information

NPI Number	:	1861083669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JOSEPH HARRISON

Provider Business Mailing Address
First Line	:	1905 N STATE ROUTE 7
Second Line	:
City	:	PLEASANT HILL
State	:	MO
Zip	:	64080-9366
Country	:	US
Telephone Number	:	816-540-4000
Fax Number	:	816-540-4341

Provider Business Practice Location Address
First Line	:	1905 N STATE ROUTE 7
Second Line	:
City	:	PLEASANT HILL
State	:	MO
Zip	:	64080-9366
Country	:	US
Telephone Number	:	816-540-4000
Fax Number	:	816-540-4341

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/03/2021

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Directions to “ MATTHEW JOSEPH HARRISON ” Practice Location

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