Provider Demographics
NPI:1619559762
Name:GERHART, MATTHEW JON (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JON
Last Name:GERHART
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 1:132 THE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828-9231
Mailing Address - Country:US
Mailing Address - Phone:814-364-2161
Mailing Address - Fax:814-364-3732
Practice Address - Street 1:132 THE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9231
Practice Address - Country:US
Practice Address - Phone:814-364-2161
Practice Address - Fax:814-364-3732
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14424183500000X
PARP438088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist