Provider Demographics
NPI:1093231300
Name:MATIA MEDICAL, LLC
Entity Type:Organization
Organization Name:MATIA MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPYROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-684-2076
Mailing Address - Street 1:519 W BUCKTHORN ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-3114
Mailing Address - Country:US
Mailing Address - Phone:214-684-2076
Mailing Address - Fax:214-594-9820
Practice Address - Street 1:519 W BUCKTHORN ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-3114
Practice Address - Country:US
Practice Address - Phone:214-684-2076
Practice Address - Fax:214-594-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies