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Individual

MATTHEW CHARLES TAHERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
1614 GLENN BLVD SW, FORT PAYNE, AL 35968-3522
(256) 845-3402
Mailing address
692 COUNTY ROAD 121, FORT PAYNE, AL 35968-5415
(256) 717-4138

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17020
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114937
AL
Enumeration date
07/10/2012
Last updated
07/10/2012
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