Matthew Estes
Individual provider Active NPI Pharmacist · Portland, TN
NPI 1386258481 · NPPES record last updated Sep 4, 2020
Key facts
- NPI
- 1386258481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 41214 (TN)
- Practice address
- 104 Highway 52 W
Portland, TN 37148-1406 - Phone
- (615) 325-4058
- NPI assigned
- Sep 4, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41214 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients |
Locations
104 Highway 52 W
Portland, TN 37148
Phone (615) 325-4058
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 41214 | TN | Yes |
Addresses
Primary practice location
104 Highway 52 W
Portland, TN 37148-1406
Mailing address
104 Highway 52 W
Portland, TN 37148-1406
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | rxm.11129@store.walgreens.com |
Other providers in Portland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2020. 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.