| Sirius Health & Wellness Llc | |
|
3181 Clearwater Drive Suite B Prescott AZ 86305 | |
| (928) 515-1755 | |
| (928) 515-2455 |
| Full Name | Sirius Health & Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3181 Clearwater Drive, Prescott, Arizona |
| Authorized Official Name and Position | Debra Ann Krupnick (OWNER/PROVIDER) |
| Authorized Official Contact | 9285151755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sirius Health & Wellness Llc 3181 Clearwater Dr Ste B Prescott AZ 86305-7196 Ph: (928) 515-1755 | Sirius Health & Wellness Llc 3181 Clearwater Drive Suite B Prescott AZ 86305 Ph: (928) 515-1755 |
| NPI Number | 1902234438 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 2769707181 |
|---|---|
| Medicare Enrollment ID | O20150205002489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902234438 | NPI | - | NPPES |
| 043346203 0078 | Other | VT | CIGNA |
| KRUP05338662 | Other | VT | BLUE CROSS BLUE SHIELD |
| ONP1198 | Medicaid | VT | |
| 043346203012 | Other | VT | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kurt A Krupnick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700836129 PECOS PAC ID: 8426157090 Enrollment ID: I20090721000023 |
| Provider Name | Debra A Krupnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568412781 PECOS PAC ID: 1658306790 Enrollment ID: I20091123000664 |
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