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MATOKE INCORPORATED SOUTHSIDE PHARMACY NPI 1700943073


NPI Information

NPI: 1700943073
Provider Name: MATOKE INCORPORATED SOUTHSIDE PHARMACY

Doing Business As: NORTHWEST PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
14041 NORTHWEST BLVD
STE 2B
CORPUS CHRISTI, TX
ZIP 78410
Phone: (361) 767-1300
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MATOKE INCORPORATED SOUTHSIDE PHARMACY is a community/retail pharmacy pharmacy in Corpus Christi, TX. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MATOKE INCORPORATED SOUTHSIDE PHARMACY NPI is 1700943073. The provider is registered as an organization entity type.
The provider Is Doing Business As Northwest Pharmacy.

The provider's business location address is:

14041 NORTHWEST BLVD
STE 2B
CORPUS CHRISTI, TX
ZIP 78410-137
Phone: (361) 767-1300
Fax: (361) 767-8888

The provider's authorized official is Eric Matoke .
The authorized official title is Pic Owner and has the following contact phone number (972) 207-0247.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 3/12/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy25349TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1145756MEDICAIDTEXAS
24543648OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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