Individual ProviderCarly ShellStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address101 S Shafer St Apt C11, Athens, OH 45701-2461(937) 570-0987PECOS EnrollmentBased on the most recent information from CMS, provider Carly Shell 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 yesterday at 10:10 AM.Profile DetailsProvider ID1114491669Provider TypeIndividualFull NameShell, CarlyGenderFemaleSole ProprietorNoEnumeration Date1/17/2019Last Updated1/17/2019Contact InformationPractice LocationPractice Address101 S Shafer St Apt C11, Athens, OH 45701-2461Phone(937) 570-0987FaxUnlisted FaxMailing LocationMailing Address8595 W Covington Gettysburg Rd, Covington, OH 45318-9701Phone(937) 570-0987FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer