Matthew R Brummer, PHARM.D.
Individual provider Active NPI Pharmacist · Atlantic, IA
NPI 1043843006 · NPPES record last updated Feb 18, 2020
Key facts
- NPI
- 1043843006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 18655 (IA)
- Practice address
- 1630 E 7TH St
Atlantic, IA 50022-1909 - Phone
- (712) 243-2240
- NPI assigned
- Feb 18, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18655 | IA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18655 | IA | Yes |
Addresses
Primary practice location
1630 E 7TH St
Atlantic, IA 50022-1909
Mailing address
902 E 17TH St
Atlantic, IA 50022-2717
Phone (712) 249-4441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18655 | Other | IA | IOWA BOARD OF PHARMACY PHARMACIST LICENCE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | n/a |
Other providers in Atlantic, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.