Mat Enterprises LLC
NPI 1972212496ActiveOrganization· Pharmacy· Holts Summit, MO
Pharmacy in Holts Summit, Missouri, registered in NPPES in November 2022. The authorized official on file is Anthonjy Desha, Owner. Enrolled in Medicare as part b supplier - mass immunization (roster biller only) and part b supplier - pharmacy.
Overview
| NPI | 1972212496 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 23, 2022 |
| Last updated in NPPES | Nov 23, 2022 |
| Certified by provider | Nov 23, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Mass Immunization (Roster Biller Only) (MO); Part B Supplier - Pharmacy (MO) |
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