Individual ProviderMarissa KoningStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address2500 Metrohealth Dr, Cleveland, OH 44109-1900(216) 778-7800PECOS EnrollmentBased on the most recent information from CMS, provider Marissa Koning 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 2 days ago.Profile DetailsProvider ID1144616616Provider TypeIndividualFull NameKoning, MarissaGenderFemaleSole ProprietorNoEnumeration Date4/12/2015Last Updated12/27/2021Contact InformationPractice LocationPractice Address2500 Metrohealth Dr, Cleveland, OH 44109-1900Phone(216) 778-7800FaxUnlisted FaxMailing LocationMailing Address2500 Metrohealth Dr, Cleveland, OH 44109-1900PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer