Individual ProviderRichard WakefieldHearing Instrument SpecialistSpeech, Language and Hearing Service ProvidersPractice Address2514 S Washington St, Grand Forks, ND 58201-6776(701) 746-7000PECOS EnrollmentBased on the most recent information from CMS, provider Richard Wakefield 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 12:57 PM.Profile DetailsProvider ID1568638294Provider TypeIndividualFull NameWakefield, RichardTitleMr.GenderMaleSole ProprietorYesEnumeration Date5/2/2008Last Updated5/2/2008Contact InformationPractice LocationPractice Address2514 S Washington St, Grand Forks, ND 58201-6776Phone(701) 746-7000Fax(701) 746-5220Mailing LocationMailing Address2514 S Washington St, Grand Forks, ND 58201-6776Phone(701) 746-7000Fax(701) 746-5220Provider TaxonomiesCodeDescriptionLicenseCode237700000XPrimaryDescriptionHearing Instrument SpecialistSpeech, Language and Hearing Service ProvidersLicenseH-0063North DakotaProvider IdentifiersIDDescriptionIssuerID7G771WADescriptionOtherIssuerBLUE CROSS & BLUE SHIELDMinnesotaID57635DescriptionMedicaidIssuerUnlistedNorth DakotaID548065500DescriptionMedicaidIssuerUnlistedMinnesotaID24303DescriptionOtherIssuerBLUE CROSS & BLUE SHIELDNorth Dakota