Provider Demographics
NPI:1447300462
Name:VACCARI, MATTHEW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:VACCARI
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 1:30 E DOVER ST
Mailing Address - Street 2:HILL'S DRUG STORE
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3048
Mailing Address - Country:US
Mailing Address - Phone:410-822-1234
Mailing Address - Fax:410-820-9057
Practice Address - Street 1:30 E DOVER ST
Practice Address - Street 2:HILL'S DRUG STORE
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3048
Practice Address - Country:US
Practice Address - Phone:410-822-1234
Practice Address - Fax:410-820-9057
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist