Individual ProviderJessica CooperriderStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address9500 Euclid Avenue/Na-23, Cleveland, OH 44195(216) 444-2200(330) 347-4946PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Cooperrider 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 4 days ago.Profile DetailsProvider ID1245819176Provider TypeIndividualFull NameCooperrider, JessicaGenderFemaleSole ProprietorYesEnumeration Date4/7/2021Last Updated4/7/2021Contact InformationPractice LocationPractice Address9500 Euclid Avenue/Na-23, Cleveland, OH 44195Phone(216) 444-2200FaxUnlisted FaxMailing LocationMailing Address13654 Fairhill Rd Apt 302, Shaker Heights, OH 44120-1252Phone(330) 347-4946FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer