Individual
MATTHEW BOURQUEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1600 E TIPTON ST, SEYMOUR, IN 47274-3560
(812) 522-5252
(812) 522-6152
Mailing address
1600 E TIPTON ST, SEYMOUR, IN 47274-3560
(812) 522-5252
(812) 522-6152
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26029257A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26029257A
INDIANA PHARMACIST LICENSE
IN
Enumeration date
10/17/2021
Last updated
10/17/2021
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