Provider Demographics
NPI:1073114856
Name:DREHER, MATTHEW SAMUEL
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SAMUEL
Last Name:DREHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:EMLENTON
Mailing Address - State:PA
Mailing Address - Zip Code:16373-0010
Mailing Address - Country:US
Mailing Address - Phone:724-867-2400
Mailing Address - Fax:724-867-6644
Practice Address - Street 1:9 E STATE ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:PA
Practice Address - Zip Code:16401-1110
Practice Address - Country:US
Practice Address - Phone:814-756-3429
Practice Address - Fax:814-756-5882
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413139L183500000X
PARP450200183500000X
PAPP410032L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist