Individual ProviderDerrick EdmondCase Manager/Care CoordinatorOther Service ProvidersPractice Address3901 Ulloa St, New Orleans, LA 70119(504) 267-5712PECOS EnrollmentBased on the most recent information from CMS, provider Derrick Edmond 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 ID1669847497Provider TypeIndividualFull NameEdmond, DerrickGenderMaleSole ProprietorYesEnumeration Date12/4/2015Last Updated6/5/2018Contact InformationPractice LocationPractice Address3901 Ulloa St, New Orleans, LA 70119Phone(504) 267-5712FaxUnlisted FaxMailing LocationMailing Address3901 Ulloa St, New Orleans, LA 70119-6942PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer