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Matthew Raymond Illich, PHARMD
Pharmacist in Gulfport, Mississippi
NPI 1558972307

Matthew Raymond Illich is a Pharmacist based in Pascagoula, MS. Matthew Raymond Illich practices in Gulfport, MS and has the professional credentials of PHARMD. The NPI Number for Matthew Raymond Illich is 1558972307 and holds a License No. 16174 (Mississippi).

The current practice location address for Matthew Raymond Illich is 1417 E Pass Rd, Gulfport, MS and can be reached out via phone at 228-896-3870.

Location: 1417 E Pass Rd, Gulfport, MS, 39581-2166
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558972307
Provider Name
Matthew Raymond Illich
Credential
PHARMD
Provider Entity Type
Individual
Gender
Male
Address
1417 E Pass Rd, Gulfport, MS, 39581-2166
Phone Number
228-896-3870
Fax Number
Provider Enumeration Date
08/14/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1417 E Pass Rd
City
Gulfport
State
Mississippi
Zip
39507-3522
Phone Number
228-896-3870
Fax Number
person
Provider Business Mailing Address Details
Address
1417 E Pass Rd
City
Gulfport
State
Mississippi
Zip
39507-3522
Phone Number
228-896-3870
Fax Number
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
-
Taxonomy
183500000X
License No.
16174 (Mississippi)
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
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