Provider Demographics
NPI:1053926162
Name:CIPPEL, MATTHEW EDMUND (PHARMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:EDMUND
Last Name:CIPPEL
Suffix:
Gender:M
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:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-0151
Mailing Address - Country:US
Mailing Address - Phone:724-763-1201
Mailing Address - Fax:
Practice Address - Street 1:401 FORD ST
Practice Address - Street 2:
Practice Address - City:FORD CITY
Practice Address - State:PA
Practice Address - Zip Code:16226-1229
Practice Address - Country:US
Practice Address - Phone:724-763-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist