Provider Demographics
NPI:1497901789
Name:MATHES PHARMACY INC.
Entity Type:Organization
Organization Name:MATHES PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-944-3612
Mailing Address - Street 1:1621 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-3339
Mailing Address - Country:US
Mailing Address - Phone:812-944-3612
Mailing Address - Fax:812-941-7303
Practice Address - Street 1:1621 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3339
Practice Address - Country:US
Practice Address - Phone:812-944-3612
Practice Address - Fax:812-941-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60002254A333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy