Justin Jerel Blackshear | Toledo, OH • PECOS Search

Justin Jerel Blackshear

Case Manager/Care Coordinator

Other Service Providers

2737 Sweetbriar Ct, Toledo, OH 43615-1868

PECOS Enrollment

Based on the most recent information from CMS, provider Justin Jerel Blackshear does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1063261378
Provider Type
Individual
Full Name
Blackshear, Justin Jerel
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
5/17/2024
Last Updated
7/10/2024

Contact Information

Practice Location

2737 Sweetbriar Ct, Toledo, OH 43615-1868

Unlisted Fax

Mailing Location

2737 Sweetbriar Ct, Toledo, OH 43615-1868

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer