Provider Demographics
NPI:1659633865
Name:OLIVIER, MATTHEW JENNINGS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JENNINGS
Last Name:OLIVIER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-3544
Mailing Address - Country:US
Mailing Address - Phone:401-575-6635
Mailing Address - Fax:
Practice Address - Street 1:22 WEAVER AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3544
Practice Address - Country:US
Practice Address - Phone:401-575-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist