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Contact Information

AGAVE MATRIX LLC
1100 S DOBSON RD STE 204
CHANDLER, AZ85286-6160
 Phone: 602-582-5233
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for AGAVE MATRIX LLC

NPI # 1578074209
LBN Legal business name AGAVE MATRIX LLC
Authorized official POLLY POLLMAN - (ADMIN)
Entity Organization
Organization subpart 1 No
Enumeration date 10/20/2017
Last updated 10/20/2017 - About 9 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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