Basic Information
Provider Information
NPI: 1467707505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: MATTHEW
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2501 PIERCE ST
Address2:  
City: SIOUX CITY
State: IA
PostalCode: 511043725
CountryCode: US
TelephoneNumber: 7122945000
FaxNumber: 7122945091
Practice Location
Address1: 2501 PIERCE ST
Address2:  
City: SIOUX CITY
State: IA
PostalCode: 511043725
CountryCode: US
TelephoneNumber: 7122945000
FaxNumber: 7122945091
Other Information
ProviderEnumerationDate: 07/15/2012
LastUpdateDate: 07/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X21666IAN Pharmacy Service ProvidersPharmacist 
1835P0018X21666IAY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
1835P1200X21666IAN Pharmacy Service ProvidersPharmacistPharmacotherapy

No ID Information.


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