Matthew Chad Tomiello, PHARM D
Individual provider Active NPI Pharmacist · Ozark, AR
NPI 1760084362 · NPPES record last updated Nov 10, 2020
Key facts
- NPI
- 1760084362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD14543 (AR)
- Practice address
- 1516 N 18TH St
Ozark, AR 72949-3611 - Phone
- (479) 667-4448
- NPI assigned
- Nov 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD14543 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past |
Accepting new patients | |
| Walmart Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD14543 | AR | Yes |
Addresses
Primary practice location
1516 N 18TH St
Ozark, AR 72949-3611
Mailing address
1404 E Buick Dr Apt 8
Fayetteville, AR 72703-4878
Other providers in Ozark, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 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.