| Regen Plus Inc | |
|
20229 N 67th Ave Ste C1a Glendale AZ 85308-6404 | |
| (602) 595-7836 | |
| (602) 419-2210 |
| Full Name | Regen Plus Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20229 N 67th Ave Ste C1a, Glendale, Arizona |
| Authorized Official Name and Position | Stephanie Knox (ADMINISTRATION) |
| Authorized Official Contact | 6022905200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regen Plus Inc 5562 W Arrowhead Lakes Dr Glendale AZ 85308-6293 Ph: (602) 290-5200 | Regen Plus Inc 20229 N 67th Ave Ste C1a Glendale AZ 85308-6404 Ph: (602) 595-7836 |
| NPI Number | 1306551569 |
|---|---|
| Provider Enumeration Date | 01/20/2023 |
| Last Update Date | 01/20/2023 |
| Medicare PECOS PAC ID | 2062879547 |
|---|---|
| Medicare Enrollment ID | O20230530001022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306551569 | NPI | - | NPPES |
| 1053742197 | Medicaid | AZ | |
| 1770088205 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Rebecca E Outwater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770088205 PECOS PAC ID: 7719241694 Enrollment ID: I20180430001836 |
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