Individual ProviderTaylor SmithCase Manager/Care CoordinatorOther Service ProvidersPractice Address1010 E 45th St, Shawnee, OK 74804-2202(405) 273-1170PECOS EnrollmentBased on the most recent information from CMS, provider Taylor Smith 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 3 days ago.Profile DetailsProvider ID1922485648Provider TypeIndividualFull NameSmith, TaylorGenderFemaleSole ProprietorYesEnumeration Date5/1/2015Last Updated5/1/2015Contact InformationPractice LocationPractice Address1010 E 45th St, Shawnee, OK 74804-2202Phone(405) 273-1170FaxUnlisted FaxMailing LocationMailing Address2703 Woodbridge Dr, Shawnee, OK 74804-1801PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer