Individual ProviderJoey Nickolas BettencourtStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(623) 561-1000(209) 204-0827PECOS EnrollmentBased on the most recent information from CMS, provider Joey Nickolas Bettencourt 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 yesterday at 1:10 PM.Profile DetailsProvider ID1568216166Provider TypeIndividualFull NameBettencourt, Joey NickolasCredentialDOGenderMaleSole ProprietorNoEnumeration Date4/11/2024Last Updated4/11/2024Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(623) 561-1000FaxUnlisted FaxMailing LocationMailing Address14002 N 49th Ave Unit 1118, Glendale, AZ 85306-4940Phone(209) 204-0827FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerArizona