Individual ProviderSerene MusallamStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(623) 561-1000(707) 290-8283PECOS EnrollmentBased on the most recent information from CMS, provider Serene Musallam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1184208241Provider TypeIndividualFull NameMusallam, SereneTitleDr.GenderFemaleSole ProprietorNoEnumeration Date5/5/2021Last Updated5/5/2021Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(623) 561-1000FaxUnlisted FaxMailing LocationMailing Address902 Rio Grande Dr, Vacaville, CA 95687-4346Phone(707) 290-8283FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerArizona