Matrix Pharmacy,LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MATRIX PHARMACY,LLC

Doing business as

Matrix Pharmacy

Practice address

5827 E 13 Mile Rd
Warren, MI 48092-1512

Phone

(586) 883-6047

Fax

(586) 883-6159

NPI assigned

Oct 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jameela Hepburn

Title

Owner

Phone

(313) 231-6627

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Matrix Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1821573130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921512",
            "telephone_number": "586-883-6047",
            "fax_number": "586-883-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5827 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921512",
            "telephone_number": "586-883-6047",
            "fax_number": "586-883-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX PHARMACY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "HEPBURN",
        "authorized_official_first_name": "JAMEELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-231-6627"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396204129",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821573130",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Masters
• Arielle Mathews
• Holly K Mathews, PA-C
• Chaka Mathiea
• Emily Mathijs, DO
• Lauren Matthews
• Lena Matti
• Olivia Matti, FNP-BC
• Samer Ablahad Matti
• Jacob Mattia

• Community/Retail Pharmacy in Warren, MI
• Providers in Warren, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.