Matoke Incorporated Southside Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25349 Issued in TX

Legal business name

MATOKE INCORPORATED SOUTHSIDE PHARMACY

Doing business as

Northwest Pharmacy

Practice address

14041 Northwest Blvd
Ste 2B
Corpus Christi, TX 78410-5137

Phone

(361) 767-1300

Fax

(361) 767-8888

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Eric Matoke, RPHNPI 1902120967

Title

Pic Owner

Phone

(972) 207-0247

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• NORTHWEST PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Onyancha Matoke, PHARMACIST

  • Pharmacist
  • Corpus Christi, TX
  • NPI 1902120967
  NPD (past) Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1700943073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14041 NORTHWEST BLVD",
            "address_2": "STE 2B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784105137",
            "telephone_number": "361-767-1300",
            "fax_number": "361-767-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14041 NORTHWEST BLVD",
            "address_2": "STE 2B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784105137",
            "telephone_number": "361-767-1300",
            "fax_number": "361-767-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATOKE INCORPORATED SOUTHSIDE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "MATOKE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PIC OWNER",
        "authorized_official_telephone_number": "972-207-0247",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145756",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4543648",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHWEST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kellie Mathieu
• Rohit Mathur, BDS, MPH, MS
• Sarona Mathware, MD
• Matisons Orthotics-Prosthetics, LLC
• Matisons Orthotics-Prosthetics, LLC
• Eric Onyancha Matoke, PHARMACIST
• Janice H Matosky, LPC, LPA, LCCA
• Matthew J Ficenec, MD, PA
• Mary McFarland Matthews, MD
• McKensi Matula, AUD

• Community/Retail Pharmacy in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.