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Audrey W Coo

Specialist

Other Service Providers

2225 Union Ave, Suite 100, Memphis, TN 38104-4316

PECOS Enrollment

This provider is enrolled in PECOS as AUDREY COO.

Based on the most recent information from CMS, provider Audrey W Coo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1114928124
Provider Type
Individual
Full Name
Coo, Audrey W
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
8/2/2005
Last Updated
7/8/2007

Contact Information

Practice Location

2225 Union Ave, Suite 100, Memphis, TN 38104-4316

(901) 726-1161

(901) 726-0161

Mailing Location

2225 Union Ave, Suite 100, Memphis, TN 38104-4316

(901) 726-1161

(901) 726-0161

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License MD29587 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 3814497	Description Medicaid	Issuer Unlisted Tennessee

Audrey W Coo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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