Organization16 Fusting Avenue Operations Llc(<Unavail>)Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address16 Fusting Ave, Catonsville, MD 21228-4413(410) 747-1800PECOS EnrollmentBased on the most recent information from CMS, provider 16 Fusting Avenue Operations Llc 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 2 days ago.Profile DetailsProvider ID1215381694Provider TypeOrganizationFull Name16 Fusting Avenue Operations LlcOther Name<Unavail>SubpartNoEnumeration Date4/21/2016Last Updated8/31/2017Contact InformationPractice LocationPractice Address16 Fusting Ave, Catonsville, MD 21228-4413Phone(410) 747-1800FaxUnlisted FaxMailing LocationMailing Address16 Fusting Ave, Catonsville, MD 21228-4413Phone(410) 747-1800FaxUnlisted FaxAuthorized OfficialNameBerg, Michael T. (Assistant Secretary)Phone(505) 468-4752Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense03018MarylandCode225X00000XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense03018MarylandProvider IdentifiersIDDescriptionIssuerID442602900DescriptionMedicaidIssuerUnlistedMaryland