1093055717 NPI number — MR. MATTHEW HOWARD FOLK PHARMD

Table of content: MR. MATTHEW HOWARD FOLK PHARMD (NPI 1093055717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093055717 NPI number — MR. MATTHEW HOWARD FOLK PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLK
Provider First Name:
MATTHEW
Provider Middle Name:
HOWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093055717
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2564 ECHO SPRINGS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17202-8082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-264-0180
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
949 LINCOLN WAY E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-261-1303
Provider Business Practice Location Address Fax Number:
717-261-5915
Provider Enumeration Date:
02/15/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP044488L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)