Matt James Cowan, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

3132 Issued in WY

Practice address

6900 Alden Dr
Ft Warren Afb, WY 82005-3906

Phone

(307) 773-3478

Fax

(307) 773-4589

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

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 and National Provider Directory roles.

• Dod Fe Warren Pharmacy

  • Military/U.S. Coast Guard Pharmacy
  • Fe Warren Afb, WY
  • NPI 1578979688
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1568520468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "city": "FT WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-3478",
            "fax_number": "307-773-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "MATT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-12284",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "355787",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "3082899-1701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "3132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teddy Lynn Ellis, D.D.S.
• Brian Patrick Hayes, MD, MPH
• Peggy Sue Kenyon, RDH
• James Louis Kretzschmar, DDS
• Perala Enterprises, LLC

• Pharmacist in Ft Warren Afb, WY
• Providers in Ft Warren Afb, WY by specialty
• Pharmacist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.