Individual provider Active NPI

Lois Matalavage, RPH

  • Pharmacist
  • New Castle, DE
National Provider Identifier
1437709904
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A1-0004000 Issued in DE
Practice address
1412 N Dupont Hwy
New Castle, DE 19720-1844
Phone
(302) 328-3175
Fax
(302) 328-4365
NPI assigned
Sep 17, 2019
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X A1-0004000 DE Primary

Addresses

Primary practice location

1412 N Dupont Hwy
New Castle, DE 19720-1844

Mailing address

110 N Princeton Ave
Wenonah, NJ 08090-2049
Phone (609) 457-2200

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
A1-0004000DEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Manor Pharmacy Inc PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1437709904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N PRINCETON AVE",
            "city": "WENONAH",
            "state": "NJ",
            "postal_code": "080902049",
            "telephone_number": "609-457-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 N DUPONT HWY",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201844",
            "telephone_number": "302-328-3175",
            "fax_number": "302-328-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATALAVAGE",
        "first_name": "LOIS",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.