Active NPI
Matthew Marian, PHARMD
- Pharmacist
- Eureka, MO
National Provider Identifier
1073100756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2019000452
- Practice address
- 245 E 5TH St
Eureka, MO 63025-1223 - Phone
- (636) 938-4102
- NPI assigned
- Dec 29, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019000452 | MO | Primary |
Addresses
Primary practice location
245 E 5TH St
Eureka, MO 63025-1223
Mailing address
385 Genoa Dr
Ballwin, MO 63021-6407
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019000452 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1073100756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 GENOA DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630216407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 E 5TH ST",
"city": "EUREKA",
"state": "MO",
"postal_code": "630251223",
"telephone_number": "636-938-4102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIAN",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2019000452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.