Individual ProviderAmanda HallStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Wyoming St, Dayton, OH 45409-2722(937) 208-2850PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Hall 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 1:10 PM.Profile DetailsProvider ID1285320416Provider TypeIndividualFull NameHall, AmandaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/12/2023Last Updated4/12/2023Contact InformationPractice LocationPractice Address1 Wyoming St, Dayton, OH 45409-2722Phone(937) 208-2850FaxUnlisted FaxMailing LocationMailing Address1 Wyoming St, Dayton, OH 45409-2722Phone(937) 208-2850FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer