OrganizationProvider Plus, IncDurable Medical Equipment & Medical SuppliesSuppliersPractice Address769 N Westwood Blvd, Poplar Bluff, MO 63901-4724(573) 686-1589PECOS EnrollmentBased on the most recent information from CMS, provider Provider Plus, Inc 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 2 days ago.Profile DetailsProvider ID1649227463Provider TypeOrganizationFull NameProvider Plus, IncSubpartNoEnumeration Date5/27/2006Last Updated10/15/2025Contact InformationPractice LocationPractice Address769 N Westwood Blvd, Poplar Bluff, MO 63901-4724Phone(573) 686-1589Fax(573) 686-1629Mailing LocationMailing Address555 E North Ln Ste 5075, Conshohocken, PA 19428-2490PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameRussalesi, Wendy (Cco)Phone(484) 246-9499Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicense14868971MissouriProvider IdentifiersIDDescriptionIssuerID629892803DescriptionMedicaidIssuerUnlistedMissouriID=========DescriptionMedicaidIssuerUnlistedIllinois