Provider Demographics
NPI:1285246934
Name:SCHAMBERGER LAI, MATTHEW VU (RPH)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:VU
Last Name:SCHAMBERGER LAI
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 1:231 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8148
Mailing Address - Country:US
Mailing Address - Phone:256-479-7655
Mailing Address - Fax:
Practice Address - Street 1:7830 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9500
Practice Address - Country:US
Practice Address - Phone:256-864-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist