Individual ProviderPeter Thomas SimonseStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(612) 561-1000PECOS EnrollmentBased on the most recent information from CMS, provider Peter Thomas Simonse 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 yesterday at 1:10 PM.Profile DetailsProvider ID1275283756Provider TypeIndividualFull NameSimonse, Peter ThomasCredentialDOGenderMaleSole ProprietorNoEnumeration Date3/27/2022Last Updated3/27/2022Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(612) 561-1000FaxUnlisted FaxMailing LocationMailing Address2425 Dunwoody Ave, Wayzata, MN 55391-8700PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer