Individual ProviderBennie OusleyCase Manager/Care CoordinatorOther Service ProvidersPractice Address829 E Main St, Blytheville, AR 72315-2521(870) 714-2188PECOS EnrollmentBased on the most recent information from CMS, provider Bennie Ousley 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 ID1104245182Provider TypeIndividualFull NameOusley, BennieTitleMr.GenderMaleSole ProprietorYesEnumeration Date4/7/2014Last Updated4/7/2014Contact InformationPractice LocationPractice Address829 E Main St, Blytheville, AR 72315-2521Phone(870) 714-2188FaxUnlisted FaxMailing LocationMailing AddressPO Box 6, Blytheville, AR 72316-0006Phone(870) 714-2188FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer