Provider Demographics
NPI:1336734268
Name:VALASEK, MATTHEW S (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:S
Last Name:VALASEK
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 1:184 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7034
Mailing Address - Country:US
Mailing Address - Phone:724-840-9348
Mailing Address - Fax:
Practice Address - Street 1:645 KOLTER DR
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3570
Practice Address - Country:US
Practice Address - Phone:724-349-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040945L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist