Provider Demographics
NPI:1144279670
Name:MATRIX OCCUPATIONAL HEALTH P.C.
Entity type:Organization
Organization Name:MATRIX OCCUPATIONAL HEALTH P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-705-8558
Mailing Address - Street 1:2145 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1546
Mailing Address - Country:US
Mailing Address - Phone:888-705-8558
Mailing Address - Fax:480-776-1605
Practice Address - Street 1:217 GLENSFORD DR
Practice Address - Street 2:SUITE A
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0892
Practice Address - Country:US
Practice Address - Phone:910-483-4647
Practice Address - Fax:910-483-6431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2344774Medicare PIN