Provider Demographics
NPI:1225352313
Name:SCRUPLES CORPORATION
Entity Type:Organization
Organization Name:SCRUPLES CORPORATION
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANGELETE
Authorized Official - Last Name:YORKE-CYRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-270-7191
Mailing Address - Street 1:6475 NEW HAMPSHIRE AVENUE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783
Mailing Address - Country:US
Mailing Address - Phone:301-270-7191
Mailing Address - Fax:301-270-7194
Practice Address - Street 1:6475 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3269
Practice Address - Country:US
Practice Address - Phone:301-270-7191
Practice Address - Fax:301-270-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4263251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417035100Medicaid