Provider Demographics
NPI:1578642989
Name:MORGAN, MATTHEW KENLEY (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:KENLEY
Last Name:MORGAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 CATAWBA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3311
Mailing Address - Country:US
Mailing Address - Phone:704-829-9897
Mailing Address - Fax:704-829-7857
Practice Address - Street 1:403 CATAWBA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3311
Practice Address - Country:US
Practice Address - Phone:704-829-9897
Practice Address - Fax:704-829-7857
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11806OtherPHARMACIST LICENSE