Provider Demographics
NPI:1063706349
Name:MATTHAES, CARRIE (PHARMD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MATTHAES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 ZOO DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3963
Mailing Address - Country:US
Mailing Address - Phone:406-601-8283
Mailing Address - Fax:406-601-8274
Practice Address - Street 1:3880 ZOO DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-3963
Practice Address - Country:US
Practice Address - Phone:406-601-8283
Practice Address - Fax:406-601-8274
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist