DR. MATTHEW MICHAEL FRERICKS (NPI# 1417940149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417940149 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW MICHAEL FRERICKS |
| Credential | PHARM.D. |
| Practice Address |
3701 Broadway St Quincy IL 62305-2821 |
| Mailing Address |
4607 Quail Creek Dr Quincy IL 62305-9222 |
| Practice Telephone | 2172249070 |
| Mailing Telephone | 2172248162 |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 044601 | MO | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659704492 | Matthew Edward Frericks | Specialist/Technologist | 710 Commerce Dr, Woodbury, MN 55125-4919 | 2013-08-15 |
| Street Address |
3701 BROADWAY ST |
| City | QUINCY |
| State | IL |
| Zip Code | 62305-2821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205867355 | Kmart Stores of Illinois LLC | Pharmacy | 3701 Broadway St, Quincy, IL 62305-2821 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386999001 | Kristi Michelle Gillette | Internal Medicine | 5011 Oak St, Quincy, IL 62305 | 2012-07-18 |
| 1447582549 | Cathi Marie Webb | Counselor | 3701 E Lake Center Dr, Suite # 8 The Shaw Building, Quincy, IL 62305 | 2010-02-01 |
| 1285804450 | Curtis D Fauble | Dentist | 4561 Maine, Quincy, IL 62305 | 2008-03-04 |
| 1598940256 | Kelley Jo Begeman | Licensed Practical Nurse | 934 North 1903 Road Lane, Quincy, IL 62305 | 2007-12-31 |
| 1649459470 | Aa Dental Care PC | Dentist | 407 So 48th Street, Quincy, IL 62305 | 2007-10-29 |
| 1982803920 | Dennis Ryan Wagner | Dentist | 407 South 48th St, Quincy, IL 62305 | 2007-07-11 |
| 1689899056 | Capelle House | Day Training, Developmentally Disabled Services | 3325 Ghost Hollow Road, Quincy, IL 62305 | 2007-04-13 |
| 1750416236 | Julie A Danker | Social Worker | 2209 N 64th St, Quincy, IL 62305 | 2007-02-23 |
| 1942812300 | Brooke N Bracy | Dentist | 4561 Maine, Quincy, IL 62305 | 2020-08-18 |
| 1558997379 | Blessing Corporate Services, Inc | Clinic/Center | 4800 Maine St, Quincy, IL 62305 | 2020-03-13 |
| Find all providers in zip 62305 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194324327 | Karen Marie Hooley | Pharmacist | 57 Hilda St Apt 4, Quincy, MA 02169-1348 | 2020-10-19 |
| 1811464795 | David Tran | Pharmacist | 814 13th Ave Sw, Quincy, WA 98848-9149 | 2018-10-29 |
| 1518335363 | Tammy Thai | Pharmacist | 50 Desmoines Rd Unit 2e, Quincy, MA 02169-8767 | 2015-09-10 |
| 1912348418 | Ryan Thurm | Pharmacist | 1825 Cherry St, Quincy, IL 62301-2113 | 2013-07-12 |
| 1164705018 | Matthew Moy | Pharmacist | 418 Quincy Avenue, Quincy, MA 02184 | 2011-09-27 |
| 1730481235 | Mark Stephen Le Roy | Pharmacist | 2270 Clear Creek Rd, Quincy, CA 95971-9734 | 2010-12-03 |
| 1154634848 | Christopher Le | Pharmacist | 343 Newport Ave, Quincy, MA 02170 | 2010-07-22 |
| 1639497126 | David Z Yu | Pharmacist | 500 Washington St Apt 506, Quincy, MA 02169 | 2010-05-10 |
| 1245557057 | Cindy Thanh Duong | Pharmacist | 475 Hancock St, Quincy, MA 02171-2414 | 2010-05-03 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.