Individual ProviderShelli BranscombSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5031 Wayne Ave, Philadelphia, PA 19144-3641(917) 399-3103PECOS EnrollmentBased on the most recent information from CMS, provider Shelli Branscomb is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1548991805Provider TypeIndividualFull NameBranscomb, ShelliGenderFemaleSole ProprietorYesEnumeration Date6/18/2022Last Updated6/18/2022Contact InformationPractice LocationPractice Address5031 Wayne Ave, Philadelphia, PA 19144-3641Phone(917) 399-3103FaxUnlisted FaxMailing LocationMailing Address5031 Wayne Ave, Philadelphia, PA 19144-3641Phone(917) 399-3103FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseCW021240Pennsylvania