SIRIUS HEALTH & WELLNESS LLC NPI 1902234438

NPI Information

NPI: 1902234438
Provider Name: SIRIUS HEALTH & WELLNESS LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 03D2068302

Address:
3181 CLEARWATER DRIVE
SUITE B
PRESCOTT, AZ
ZIP 86305
Phone: (928) 899-8782
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SIRIUS HEALTH & WELLNESS LLC is a health service clinic center in Prescott, AZ. SIRIUS HEALTH & WELLNESS LLC NPI is 1902234438. The provider is registered as an organization entity type.

The provider's business location address is:

3181 CLEARWATER DRIVE
SUITE B
PRESCOTT, AZ
ZIP 86305
Phone: (928) 899-8782
Fax: (928) 771-5471

The provider's authorized official is Debra Ann Krupnick .
The authorized official title is Owner/provider and has the following contact phone number (928) 899-8782.

The CLIA number assigned to this NPI record is 03D2068302 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2013 and was last updated on 10/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	APO522	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	043346203 0078	OTHER	VERMONT	CIGNA
2	043346203012	OTHER	VERMONT	TRICARE
3	S62710	MEDICARE UPIN	VERMONT
4	ONP1198	MEDICAID	VERMONT
5	KRUP05338662	OTHER	VERMONT	BLUE CROSS BLUE SHIELD
6	MB0243991	OTHER	VERMONT	DEA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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