Individual ProviderRandy GutierrezCase Manager/Care CoordinatorOther Service ProvidersPractice Address203 California St NE, Albuquerque, NM 87108-1802(505) 308-8296PECOS EnrollmentBased on the most recent information from CMS, provider Randy Gutierrez is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1952170649Provider TypeIndividualFull NameGutierrez, RandyGenderMaleSole ProprietorNoEnumeration Date12/22/2023Last Updated12/22/2023Contact InformationPractice LocationPractice Address203 California St NE, Albuquerque, NM 87108-1802Phone(505) 308-8296Fax(505) 433-5096Mailing LocationMailing Address203 California St NE, Albuquerque, NM 87108-1802Phone(505) 308-8296Fax(505) 433-5096Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer