Logan Reid Mathies, PHARMD
Individual provider Active NPI Pharmacist · Rock Hill, MO
NPI 1316620347 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1316620347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2023032339 (MO)
- Practice address
- 9801 Manchester Rd
Rock Hill, MO 63119 - Phone
- (314) 963-3256
- NPI assigned
- Aug 8, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 2023032339 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
9801 Manchester Rd
Saint Louis, MO 63119
Phone (314) 963-3256
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2023032339 | MO | Yes |
Addresses
Primary practice location
9801 Manchester Rd
Rock Hill, MO 63119
Mailing address
9801 Manchester Rd
Rock Hill, MO 63119
Phone (314) 963-3256
Other providers in Rock Hill, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. 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.