Individual ProviderOdie C PauleyNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2100 Harrison Ave, Panama City, FL 32405-4546(850) 260-6566PECOS EnrollmentThis provider is enrolled in PECOS as ODIE PAULEY.Based on the most recent information from CMS, provider Odie C Pauley is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1235822495Provider TypeIndividualFull NamePauley, Odie CTitleMr.CredentialAPRNGenderMaleSole ProprietorNoEnumeration Date6/1/2023Last Updated6/1/2023Contact InformationPractice LocationPractice Address2100 Harrison Ave, Panama City, FL 32405-4546Phone(850) 260-6566FaxUnlisted FaxMailing LocationMailing Address1076 Ten Mile Rd, Bonifay, FL 32425-3577Phone(850) 260-6566FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11026660Florida