Individual ProviderConrad EkellemCase Manager/Care CoordinatorOther Service ProvidersPractice Address2041 Mlk Jr Ave Es, Washington Dc, DC 20020(202) 744-0484PECOS EnrollmentBased on the most recent information from CMS, provider Conrad Ekellem 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 10:04 AM.Profile DetailsProvider ID1124700646Provider TypeIndividualFull NameEkellem, ConradGenderMaleSole ProprietorYesEnumeration Date8/3/2023Last Updated8/3/2023Contact InformationPractice LocationPractice Address2041 Mlk Jr Ave Es, Washington Dc, DC 20020Phone(202) 744-0484FaxUnlisted FaxMailing LocationMailing Address11640 Lockwood Dr Apt 104, Silver Spring, MD 20904-2311PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer