Individual provider Active NPI

Matthew Edward Cothron

  • Pharmacy Technician
  • Warren, MI
National Provider Identifier
1871265348
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
5303007534 Issued in MI
Practice address
2003 E 12 Mile Rd
Warren, MI 48092-5642
Phone
(586) 751-3600
Fax
(586) 751-1257
NPI assigned
Oct 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 5303007534 MI Primary

Addresses

Primary practice location

2003 E 12 Mile Rd
Warren, MI 48092-5642

Mailing address

8529 Harding
Center Line, MI 48015-1557
Phone (248) 238-6874

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
5303007534MIMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1871265348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8529 HARDING",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151557",
            "telephone_number": "248-238-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925642",
            "telephone_number": "586-751-3600",
            "fax_number": "586-751-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTHRON",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "5303007534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.