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O'Connell Caleb Penrose

Internal Medicine

Allopathic & Osteopathic Physicians

743 Spring St NE Rear 710, Gainesville, GA 30501-3899

PECOS Enrollment

This provider is enrolled in PECOS as O'CONNELL PENROSE.

Based on the most recent information from CMS, provider O'Connell Caleb Penrose is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1548947971
Provider Type
Individual
Full Name
Penrose, O'Connell Caleb
Gender
Male

Sole Proprietor
No
Enumeration Date
6/28/2023
Last Updated
6/28/2023

Contact Information

Practice Location

743 Spring St NE Rear 710, Gainesville, GA 30501-3899

(770) 219-0020

Unlisted Fax

Mailing Location

743 Spring St NE Ste 710, Gainesville, GA 30501-3715

(770) 219-0020

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 14865 Georgia

O'Connell Caleb Penrose

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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