Individual ProviderRoss TanickStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address601 E Hampden Ave Ste 470, Englewood, CO 80113-2797(303) 788-3100PECOS EnrollmentBased on the most recent information from CMS, provider Ross Tanick 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 4 days ago.Profile DetailsProvider ID1093149254Provider TypeIndividualFull NameTanick, RossGenderMaleSole ProprietorNoEnumeration Date8/23/2013Last Updated4/10/2023Contact InformationPractice LocationPractice Address601 E Hampden Ave Ste 470, Englewood, CO 80113-2797Phone(303) 788-3100FaxUnlisted FaxMailing LocationMailing Address601 E Hampden Ave Ste 470, Englewood, CO 80113-2797Phone(303) 788-3100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDUNKNOWNDescriptionMedicaidIssuerUnlistedColorado