Individual ProviderSamuel AlfredCase Manager/Care CoordinatorOther Service ProvidersPractice Address5301 Nebraska Ave, Toledo, OH 43615-4632(419) 531-5544(419) 265-0693PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Alfred 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 7 days ago.Profile DetailsProvider ID1720574221Provider TypeIndividualFull NameAlfred, SamuelTitleMr.CredentialCDCAGenderMaleSole ProprietorNoEnumeration Date7/8/2018Last Updated7/8/2018Contact InformationPractice LocationPractice Address5301 Nebraska Ave, Toledo, OH 43615-4632Phone(419) 531-5544Fax(419) 531-5117Mailing LocationMailing Address1064 Markham Ct, Toledo, OH 43615-6727Phone(419) 265-0693FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseCDCA.165458Ohio