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NPI Code Detail

MEDICARE: MR. MATTHEW B PURVIS PHARMD

MEDICARE:  MR. MATTHEW B PURVIS  PHARMD
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
1183500000XPharmacistE-14378MS

General Provider Information

NPI Number : 1912509530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW B PURVIS PHARMD
Provider Business Mailing Address
First Line : 15552 HIGHWAY 503
Second Line :
City : DECATUR
State : MS
Zip : 39327-9686
Country : US
Telephone Number : 662-816-8756
Fax Number :
Provider Business Practice Location Address
First Line : 1002 W BEACON ST
Second Line :
City : PHILADELPHIA
State : MS
Zip : 39350-3204
Country : US
Telephone Number : 601-656-5310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 11/09/2020

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Directions to “ MR. MATTHEW B PURVIS PHARMD” Practice Location

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