Individual ProviderDouglas Spaeth-CookStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address204 Grosvenor Hl, Athens, OH 45701-1775(614) 793-5561PECOS EnrollmentBased on the most recent information from CMS, provider Douglas Spaeth-Cook is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 10:10 AM.Profile DetailsProvider ID1972171627Provider TypeIndividualFull NameSpaeth-Cook, DouglasGenderMaleSole ProprietorNoEnumeration Date6/17/2021Last Updated6/17/2021Contact InformationPractice LocationPractice Address204 Grosvenor Hl, Athens, OH 45701-1775Phone(614) 793-5561FaxUnlisted FaxMailing LocationMailing Address204 Grosvenor Hl, Athens, OH 45701-1775Phone(614) 793-5561FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer