Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Ira Van Matre

Individual provider Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · NPI 1396621306

Mark Ira Van Matre is a Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in London, Ohio. Licensed in Ohio. Registered with an NPI since 2025.

Licensed in
OH
In the registry since
2025

Practice location Address checks out

230 Lafayette St
London, OH 43140-9059
Phone: (740) 852-7550
Fax: (740) 852-7551
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (primary) Taxonomy 1835P0018X · Licence 03445796 (OH)

Record details

NPI number1396621306
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 14, 2025
Last updated in NPPESAugust 14, 2025
Certification dateAugust 14, 2025
Mailing address124 Regency Dr, Cedarville, OH 45314-9501

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