| Vivify Wellness Center | |
|
500 S Westgate Way Suite #300 Wylie TX 75098-5308 | |
| (972) 941-8484 | |
| (972) 941-8480 |
| Full Name | Vivify Wellness Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 500 S Westgate Way, Wylie, Texas |
| Authorized Official Name and Position | Kenechim Anamekwe (PRESIDENT) |
| Authorized Official Contact | 9729418484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivify Wellness Center Po Box 1119 Wylie TX 75098-1119 Ph: (972) 941-8484 | Vivify Wellness Center 500 S Westgate Way Suite #300 Wylie TX 75098-5308 Ph: (972) 941-8484 |
| NPI Number | 1811371388 |
|---|---|
| Provider Enumeration Date | 07/15/2015 |
| Last Update Date | 07/15/2015 |
| Medicare PECOS PAC ID | 8921302365 |
|---|---|
| Medicare Enrollment ID | O20160205000833 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811371388 | NPI | - | NPPES |
| Provider Name | Kenechim A Anamekwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891996112 PECOS PAC ID: 0749478048 Enrollment ID: I20110103000129 |
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