Ricky N Blake | Saint Louis, MO • PECOS Search

Ricky N Blake

Home Health

Agencies

7502 W Florissant Ave, Saint Louis, MO 63136-1342

PECOS Enrollment

Based on the most recent information from CMS, provider Ricky N Blake 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 3 days ago.

Profile Details

Provider ID
1164290532
Provider Type
Individual
Full Name
Blake, Ricky N
Gender
Male

Sole Proprietor
Yes
Enumeration Date
12/15/2023
Last Updated
12/15/2023

Contact Information

Practice Location

7502 W Florissant Ave, Saint Louis, MO 63136-1342

Unlisted Fax

Mailing Location

7502 W Florissant Ave, Saint Louis, MO 63136-1342

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 251E00000X Primary	Description Home Health Agencies	License Unlisted Issuer