Provider Demographics
NPI:1669040135
Name:MATOVICH ENTERPRISES INC
Entity Type:Organization
Organization Name:MATOVICH ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHARMACY TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-860-4424
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-0719
Mailing Address - Country:US
Mailing Address - Phone:406-860-4424
Mailing Address - Fax:
Practice Address - Street 1:133 N 5TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MT
Practice Address - Zip Code:59019-7700
Practice Address - Country:US
Practice Address - Phone:406-860-4424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy