Provider Demographics
NPI:1720301484
Name:MATTHEWS, JAMES CHARLES (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHARLES
Last Name:MATTHEWS
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 1:323 CLEMS RUN
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2853
Mailing Address - Country:US
Mailing Address - Phone:856-478-0428
Mailing Address - Fax:
Practice Address - Street 1:600 ALLENDALE RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4054
Practice Address - Country:US
Practice Address - Phone:800-422-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035402L183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP035402LOtherPA BOARD OF PHARMACY LICENSE