Individual ProviderPatrick GruganSocial WorkerBehavioral Health & Social Service ProvidersPractice Address270 W Walnut Ln # 2d, Philadelphia, PA 19144-3204(215) 399-6215PECOS EnrollmentBased on the most recent information from CMS, provider Patrick Grugan 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 2 days ago.Profile DetailsProvider ID1952843732Provider TypeIndividualFull NameGrugan, PatrickCredentialLCSWGenderMaleSole ProprietorNoEnumeration Date11/10/2016Last Updated12/6/2023Contact InformationPractice LocationPractice Address270 W Walnut Ln # 2d, Philadelphia, PA 19144-3204Phone(215) 399-6215FaxUnlisted FaxMailing LocationMailing Address270 W Walnut Ln # 2d, Philadelphia, PA 19144-3204Phone(215) 399-6215FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseCW020620PennsylvaniaCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseSW133896Pennsylvania