| Scrappy Enterprises, Inc | |
|
300 W Douglas Ave Ste 205 Wichita KS 67202-2904 | |
| (316) 759-9136 | |
| (316) 500-7862 |
| Full Name | Scrappy Enterprises, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 W Douglas Ave Ste 205, Wichita, Kansas |
| Authorized Official Name and Position | Janel Sanford (CEO) |
| Authorized Official Contact | 3167599136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scrappy Enterprises, Inc 300 W Douglas Ave Ste 205 Wichita KS 67202-2904 Ph: (316) 759-9136 | Scrappy Enterprises, Inc 300 W Douglas Ave Ste 205 Wichita KS 67202-2904 Ph: (316) 759-9136 |
| NPI Number | 1700408119 |
|---|---|
| Provider Enumeration Date | 05/08/2020 |
| Last Update Date | 05/12/2020 |
| Certification Date | 05/12/2020 |
| Medicare PECOS PAC ID | 1759779093 |
|---|---|
| Medicare Enrollment ID | O20220202000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700408119 | NPI | - | NPPES |
| Provider Name | Anaidy Claudio Rosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629472691 PECOS PAC ID: 2365797388 Enrollment ID: I20180615000742 |
| Provider Name | Janel Sanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083017099 PECOS PAC ID: 4981092806 Enrollment ID: I20220202000821 |
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