Individual provider Active NPI

Manjit Singh Matharu

  • Pharmacist
  • Plant City, FL
National Provider Identifier
1356474308
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS32197 Issued in FL
Practice address
1423 S Collins St
Plant City, FL 33563-6577
Phone
(813) 752-1133
Fax
(813) 752-8866
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS32197 FL Primary

Addresses

Primary practice location

1423 S Collins St
Plant City, FL 33563-6577

Mailing address

1423 S Collins St
Plant City, FL 33563-6577
Phone (813) 752-1133

Other practice location 1

12620 US Highway 301
Dade City, FL 33525-6058
Phone (352) 521-0155

Other identifiers 1

IdentifierTypeStateIssuer
32197OtherFLFL PHARMACY LICENSE NUMBE

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

State licenses

LicenseStateTypeSpecialty
PS32197FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Super Discount Pharmacy LLC Current Accepting new patients
MMRX Healthsolutions Inc Past Accepting new patients

Locations

1423 S Collins St
Plant City, FL 33563
Phone (813) 752-1133

Organizations & group practices 2

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1356474308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 S COLLINS ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335636577",
            "telephone_number": "813-752-1133",
            "fax_number": "813-752-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 S COLLINS ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335636577",
            "telephone_number": "813-752-1133",
            "fax_number": "813-752-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12620 US Highway 301",
            "address_purpose": "LOCATION",
            "city": "Dade City",
            "state": "FL",
            "postal_code": "335256058",
            "country_code": "US",
            "telephone_number": "352-521-0155",
            "fax_number": "352-521-0675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHARU",
        "first_name": "MANJIT",
        "middle_name": "SINGH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS32197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL PHARMACY LICENSE NUMBE",
            "identifier": "32197",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.