Individual ProviderAudrey Lucretia JohnsonCase Manager/Care CoordinatorOther Service ProvidersPractice Address5577 Airport Hwy Ste 200, Toledo, OH 43615-7364(567) 343-7233(419) 764-7341PECOS EnrollmentBased on the most recent information from CMS, provider Audrey Lucretia Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1033954680Provider TypeIndividualFull NameJohnson, Audrey LucretiaCredentialBSGenderFemaleSole ProprietorYesEnumeration Date6/26/2024Last Updated7/18/2024Contact InformationPractice LocationPractice Address5577 Airport Hwy Ste 200, Toledo, OH 43615-7364Phone(567) 343-7233FaxUnlisted FaxMailing LocationMailing Address335 Winthrop St Fl 2, Toledo, OH 43620-1257Phone(419) 764-7341FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer