Mata-5 Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010140 Issued in MI

Legal business name

MATA-5 INC.

Doing business as

Devz Pharmacy II

Practice address

6624 N Canton Center Rd
Canton, MI 48187-1651

Phone

(734) 335-6312

Fax

(313) 202-8233

NPI assigned

Jul 24, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Washdev S Mata, RPHNPI 1346682952

Title

Ceo

Phone

(734) 335-6312

Specialties & licenses 1

Addresses

Other names 1

• Devz Pharmacy II Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Washdev S Mata, RPH

  • Pharmacist
  • Canton, MI
  • NPI 1346682952
  NPD Authorized official

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1861834483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871249",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876249",
            "telephone_number": "734-335-6312",
            "fax_number": "313-202-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871651",
            "telephone_number": "734-335-6312",
            "fax_number": "313-202-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATA-5 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "WASHDEV",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-335-6312",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devz Pharmacy II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Canton, MI
• Providers in Canton, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.