Charmelle Renee Jackson | Washington, DC • PECOS Search

Charmelle Renee Jackson

Case Manager/Care Coordinator

Other Service Providers

3712 Carpenter St SE, Washington, DC 20020-2340

PECOS Enrollment

Based on the most recent information from CMS, provider Charmelle Renee Jackson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1245934728
Provider Type
Individual
Full Name
Jackson, Charmelle Renee
Gender
Female

Sole Proprietor
No
Enumeration Date
3/28/2023
Last Updated
3/28/2023

Contact Information

Practice Location

3712 Carpenter St SE, Washington, DC 20020-2340

Unlisted Fax

Mailing Location

3712 Carpenter St SE, Washington, DC 20020-2340

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer