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Larry Blaine Mahood

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

100 S 10th St, Lillington, NC 27546-6690

PECOS Enrollment

This provider is enrolled in PECOS as LARRY MAHOOD.

Based on the most recent information from CMS, provider Larry Blaine Mahood 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 2 days ago.

Profile Details

Provider ID
1700130333
Provider Type
Individual
Full Name
Mahood, Larry Blaine
Credential
PA-C

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/5/2012
Last Updated
11/5/2012

Contact Information

Practice Location

100 S 10th St, Lillington, NC 27546-6690

(910) 893-4111

(910) 893-9850

Mailing Location

100 S 10th St, Lillington, NC 27546-6690

(910) 893-4111

(910) 893-9850

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-03901 North Carolina

Larry Blaine Mahood

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ledgett, Julia Ashton

Turner, Melissa Beth

Irwin, Hope

Torres, Monique

Debetta, Johnathan Donald

Goo, Bianca L

Ovens, Leonard R.

Han, Christine

Rushton, Samantha Joelle

Price, Anne