Individual ProviderDarrnell WallaceCase Manager/Care CoordinatorOther Service ProvidersPractice Address4675 Ventura Dr, Toledo, OH 43615-6143(419) 973-8089PECOS EnrollmentBased on the most recent information from CMS, provider Darrnell Wallace 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 ID1548064694Provider TypeIndividualFull NameWallace, DarrnellGenderMaleSole ProprietorYesEnumeration Date4/1/2025Last Updated4/1/2025Contact InformationPractice LocationPractice Address4675 Ventura Dr, Toledo, OH 43615-6143Phone(419) 973-8089FaxUnlisted FaxMailing LocationMailing Address4675 Ventura Dr, Toledo, OH 43615-6143Phone(419) 973-8089FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer