Individual ProviderMaxwell HogueNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232(401) 649-4020(603) 667-6765PECOS EnrollmentBased on the most recent information from CMS, provider Maxwell Hogue is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1235789231Provider TypeIndividualFull NameHogue, MaxwellGenderMaleSole ProprietorNoEnumeration Date9/12/2019Last Updated1/5/2023Contact InformationPractice LocationPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232Phone(401) 649-4020Fax(401) 649-4021Mailing LocationMailing Address619 Boston Neck Rd, North Kingstown, RI 02852-6235Phone(603) 667-6765FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN02399Rhode IslandCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN2313022Massachusetts