Provider Demographics
NPI:1447140306
Name:NOBLE CARE APOTHECARY 2
Entity type:Organization
Organization Name:NOBLE CARE APOTHECARY 2
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:248-302-7919
Mailing Address - Street 1:7362 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1508
Mailing Address - Country:US
Mailing Address - Phone:248-461-6509
Mailing Address - Fax:248-599-9266
Practice Address - Street 1:2900 UNION LAKE RD STE 213
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3526
Practice Address - Country:US
Practice Address - Phone:248-461-6509
Practice Address - Fax:248-599-9266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy