Carlisle, Matthew Jay

Carlisle, Matthew Jay is an individual health care provider with primary practice located at 1032 Crosswinds Ct , Wentzville MO 63385-4836. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Carlisle, Matthew Jay can be contacted via phone (636) 327-3560.

Contact Information

Primary practice address
1032 Crosswinds Ct Wentzville MO 63385-4836
Phone: (636) 327-3560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 051035160 Illinois
Pharmacy Service Providers / Pharmacist 183500000X 090974 Missouri

Profile Details

NPI number 1700357134
LBN Legal business name Carlisle, Matthew Jay
Credentials R.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2018
Last updated Dec 11th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700357134 NPPES
Illinois Other 051035160 ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION - PHARMACIST
Illinois Other 040974 ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION - PHARMACIST

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