Individual ProviderVicki ChildressCase Manager/Care CoordinatorOther Service ProvidersPractice Address506 W Jackman St, Lancaster, CA 93534-2531(661) 802-1728PECOS EnrollmentBased on the most recent information from CMS, provider Vicki Childress 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 ID1760124549Provider TypeIndividualFull NameChildress, VickiGenderFemaleSole ProprietorNoEnumeration Date4/11/2022Last Updated4/11/2022Contact InformationPractice LocationPractice Address506 W Jackman St, Lancaster, CA 93534-2531Phone(661) 802-1728FaxUnlisted FaxMailing LocationMailing Address1718 Bow Way, Lancaster, CA 93534-5133Phone(661) 802-1728FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer