Janice Sanford-Russo | Shaker Heights, OH • PECOS Search

Janice Sanford-Russo

Social Worker

Behavioral Health & Social Service Providers

22001 Fairmount Blvd, Shaker Heights, OH 44118-4819

(216) 932-2800 (216) 573-6946

PECOS Enrollment

Based on the most recent information from CMS, provider Janice Sanford-Russo is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1528361474
Provider Type
Individual
Full Name
Sanford-Russo, Janice
Credential
LISW-S

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/15/2010
Last Updated
12/15/2010

Contact Information

Practice Location

22001 Fairmount Blvd, Shaker Heights, OH 44118-4819

Unlisted Fax

Mailing Location

5708 Chestnut Rd, Independence, OH 44131-3371

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0004339 Ohio