Individual ProviderLarry DemersRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1511PECOS EnrollmentBased on the most recent information from CMS, provider Larry Demers 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 2 days ago.Profile DetailsProvider ID1053488296Provider TypeIndividualFull NameDemers, LarryCredentialRNGenderMaleSole ProprietorNoEnumeration Date11/30/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1511Fax(602) 263-1619Mailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 263-1511Fax(602) 263-1619Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN122343Arizona