Individual ProviderMarc RademakerStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address19555 N 59th Ave, Glendale, AZ 85308-6813(623) 572-3447PECOS EnrollmentBased on the most recent information from CMS, provider Marc Rademaker is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1225882558Provider TypeIndividualFull NameRademaker, MarcGenderMaleSole ProprietorNoEnumeration Date4/15/2024Last Updated5/27/2025Contact InformationPractice LocationPractice Address19555 N 59th Ave, Glendale, AZ 85308-6813Phone(623) 572-3447FaxUnlisted FaxMailing LocationMailing Address640 Jackson St, Saint Paul, MN 55101-2502PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer