Matthew A Taylor, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302028116 Issued in MI

Practice address

3990 24TH Ave
Port Huron, MI 48060-1527

Phone

(810) 987-4679

Fax

(810) 987-4694

NPI assigned

Oct 27, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Port Huron, MI
  • NPI 1073520060
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1275819856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 24TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601527",
            "telephone_number": "810-987-4679",
            "fax_number": "810-987-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 24TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601527",
            "telephone_number": "810-987-4679",
            "fax_number": "810-987-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN BOARD OF PHARMACY",
            "identifier": "5302028116",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Taube
• Sara M Tavora, LMSW
• Breonna Taylor
• Carrie Taylor, LPC
• Laura Elizabeth Taylor
• Melissa Kay Taylor
• Sierra Skie Taylor
• Hargopal Tekumulla, PT
• Sushree Tekumulla, OT
• Telesha Temple, LBSW

• Pharmacist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.