Individual ProviderLarry GreenCase Manager/Care CoordinatorOther Service ProvidersPractice Address111 S Byrne Rd, Toledo, OH 43615-6212(419) 531-5544PECOS EnrollmentBased on the most recent information from CMS, provider Larry Green 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 7 days ago.Profile DetailsProvider ID1427658673Provider TypeIndividualFull NameGreen, LarryTitleMr.GenderMaleSole ProprietorNoEnumeration Date10/27/2020Last Updated12/18/2020Contact InformationPractice LocationPractice Address111 S Byrne Rd, Toledo, OH 43615-6212Phone(419) 531-5544Fax(419) 531-5117Mailing LocationMailing AddressPO Box 20068, Toledo, OH 43610-0068Phone(419) 531-5544Fax(419) 531-5117Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerOhio