Individual ProviderAlexis MackLicensed Practical NurseNursing Service ProvidersPractice Address2 Cahill St, Amityville, NY 11701-1858(631) 789-8525PECOS EnrollmentBased on the most recent information from CMS, provider Alexis Mack 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 yesterday at 9:43 AM.Profile DetailsProvider ID1992097802Provider TypeIndividualFull NameMack, AlexisCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date5/11/2011Last Updated5/11/2011Contact InformationPractice LocationPractice Address2 Cahill St, Amityville, NY 11701-1858Phone(631) 789-8525Fax(631) 789-4086Mailing LocationMailing Address2 Cahill St, Amityville, NY 11701-1858Phone(631) 789-8525Fax(631) 789-4086Provider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense293904-1New York