Matthew Daniels, PHARMD
Individual provider Active NPI Pharmacist · Sonora, KY
NPI 1801169016 · NPPES record last updated Nov 12, 2021
Key facts
- NPI
- 1801169016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 011545 (KY)
- Practice address
- 12134 S Dixie Hwy
Sonora, KY 42776-9739 - Phone
- (270) 949-3494
- Fax
- (270) 949-3494
- NPI assigned
- Feb 18, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 011545 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Dixie Pharmacy LLC | Current |
Accepting new patients | |
| South Dixie Pharmacy LLC | Current | Accepting new patients |
Locations
12134 S Dixie Hwy
Sonora, KY 42776
Phone (270) 949-3494
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011545 | KY | Yes |
Addresses
Primary practice location
12134 S Dixie Hwy
Sonora, KY 42776-9739
Mailing address
12134 S Dixie Hwy
Sonora, KY 42776-9739
Phone (270) 949-3494
Other providers in Sonora, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2021. 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.