Individual provider Active NPI

Manal Motawadee Zarekh Matta

  • Pharmacist
  • Martinsburg, WV
National Provider Identifier
1871155374
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH100002426 Issued in DC
Practice address
33 Meadow LN Unit 7
Martinsburg, WV 25404-3807
Phone
(681) 247-2385
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH100002426 DC Primary

Addresses

Primary practice location

33 Meadow LN Unit 7
Martinsburg, WV 25404-3807

Mailing address

14461 Saint Germain Dr
Centreville, VA 20121-2225
Phone (703) 206-8301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH100002426DCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
MZM Pharmacy LLC Community/Retail Pharmacy CurrentSince Aug 1, 2019 Accepting new patients

Locations

33 Meadow Ln
Unit 7
Martinsburg, WV 25404
Phone (681) 247-2385

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1871155374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14461 SAINT GERMAIN DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212225",
            "telephone_number": "703-206-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MEADOW LN UNIT 7",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254043807",
            "telephone_number": "681-247-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "MANAL",
        "middle_name": "MOTAWADEE ZAREKH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DC",
            "license": "PH100002426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.