Individual ProviderRamata DialloNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1180 Professional Ct, Hagerstown, MD 21740-5852(301) 791-3045(301) 675-5413PECOS EnrollmentBased on the most recent information from CMS, provider Ramata Diallo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1679293047Provider TypeIndividualFull NameDiallo, RamataGenderFemaleSole ProprietorYesEnumeration Date8/29/2022Last Updated12/13/2023Contact InformationPractice LocationPractice Address1180 Professional Ct, Hagerstown, MD 21740-5852Phone(301) 791-3045FaxUnlisted FaxMailing LocationMailing Address12406 Fallen Timbers Cir, Hagerstown, MD 21740-1078Phone(301) 675-5413FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR203515Maryland