Individual provider Active NPI

Fouad A Matta, RPH

  • Pharmacist
  • Sterling Heights, MI
National Provider Identifier
1316018419
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302027183 Issued in MI
Practice address
34644 Dequindre Rd
Sterling Heights, MI 48310-5233
Phone
(586) 698-0336
Fax
(586) 698-0344
NPI assigned
Nov 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302027183 MI Primary

Addresses

Primary practice location

34644 Dequindre Rd
Sterling Heights, MI 48310-5233

Mailing address

34644 Dequindre Rd
Sterling Heights, MI 48310-5233
Phone (586) 698-0336

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302027183MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sema Pharm LLC CurrentSince Aug 4, 2024 Accepting new patients
Sema Pharm LLC CurrentSince Nov 5, 2023 Accepting new patients
Lafayette Drugs Inc Past Accepting new patients
Parkview Pharmacy LLC PastSince Apr 11, 2021 Accepting new patients

Locations

34644 Dequindre Rd
Sterling Heights, MI 48310
Phone (586) 698-0336

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699056000000",
    "number": "1316018419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34644 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105233",
            "telephone_number": "586-698-0336",
            "fax_number": "313-698-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34644 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105233",
            "telephone_number": "586-698-0336",
            "fax_number": "586-698-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "FOUAD",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2023; 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.