Healthcare Provider Details

I. General information

NPI: 1225872658
Provider Name (Legal Business Name): CARIS MPI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 E COTTON CENTER BLVD
PHOENIX AZ
85040-8900
US

IV. Provider business mailing address

750 WEST JOHN CARPENTER FREEWAY, ATTN: KELLY BERMAN SUITE 800
IRVING TX
75039
US

V. Phone/Fax

Practice location:
  • Phone: 888-979-8669
  • Fax:
Mailing address:
  • Phone: 888-979-8669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LUKE POWER
Title or Position: CFO
Credential:
Phone: 888-979-8669