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Amanda Renee Pickles

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3400 Spruce St, 3 Dulles Building, Philadelphia, PA 19104-4206

PECOS Enrollment

This provider is enrolled in PECOS as AMANDA PICKLES.

Based on the most recent information from CMS, provider Amanda Renee Pickles is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1679755169
Provider Type
Individual
Full Name
Pickles, Amanda Renee
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/27/2007
Last Updated
3/18/2011

Contact Information

Practice Location

3400 Spruce St, 3 Dulles Building, Philadelphia, PA 19104-4206

(215) 349-8222

Unlisted Fax

Mailing Location

3400 Spruce St, 3 Dulles Building, Philadelphia, PA 19104-4206

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License MA052629 Pennsylvania

Amanda Renee Pickles

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hogan, Kamini B

Dymond, Daniel James

Palumbo, Kurt Daniel

Mandia, Sofia Marie

Miller, Megan

Cun, Ann Sau

Gitter, Benjamin

Ou, Jennifer M.

Monterrosa, Christina

Engeland, Megan Elizabeth