Lena Matti, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302415675 Issued in MI

Practice address

4514 Gratiot Rd
Kimball, MI 48074-4508

Phone

(810) 364-6980

NPI assigned

Dec 18, 2023

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woodward Detroit CVS, L.L.C.

  dba CVS Pharmacy #08053

  • Pharmacy
  • Kimball, MI
  • NPI 1013029958
  NPD (past)

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1346018546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16690 TOWER DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442043",
            "telephone_number": "248-835-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 GRATIOT RD",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480744508",
            "telephone_number": "810-364-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTI",
        "first_name": "LENA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302415675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimball Family Dental
• Bailey Christine Klein, DMD
• Sherri Ann Lester, CPHT
• Christopher Mangin, D.C.
• Mark a Topolewski OD and Associates PC
• Shelby McCormick
• Jamie Meier
• Kimberly Dianne Melton, RD
• Jenna Lynn Miller, FNP-BC
• Nancy Rietdorf PHD PLLC

• Pharmacist in Kimball, MI
• Providers in Kimball, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.