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Justin Timothy Mccarthy

Physical Medicine & Rehabilitation

Allopathic & Osteopathic Physicians

200 Jefferson Ave SE, Grand Rapids, MI 49503-4502

PECOS Enrollment

This provider is enrolled in PECOS as JUSTIN MCCARTHY.

Based on the most recent information from CMS, provider Justin Timothy Mccarthy 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 yesterday at 10:10 AM.

Profile Details

Provider ID
1548957376
Provider Type
Individual
Full Name
Mccarthy, Justin Timothy
Gender
Male

Sole Proprietor
No
Enumeration Date
4/21/2023
Last Updated
4/21/2023

Contact Information

Practice Location

200 Jefferson Ave SE, Grand Rapids, MI 49503-4502

(616) 685-6867

Unlisted Fax

Mailing Location

200 Jefferson Ave SE, Grand Rapids, MI 49503-4502

(616) 685-6867

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208100000X Primary	Description Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians	License 4351050994 Michigan

Justin Timothy Mccarthy

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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