Individual ProviderJames StathakiosStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3000 Arlington Ave, Toledo, OH 43614-2595(419) 383-6462(248) 765-6913PECOS EnrollmentBased on the most recent information from CMS, provider James Stathakios 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 3 days ago.Profile DetailsProvider ID1255913752Provider TypeIndividualFull NameStathakios, JamesTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date4/23/2021Last Updated6/30/2022Contact InformationPractice LocationPractice Address3000 Arlington Ave, Toledo, OH 43614-2595Phone(419) 383-6462FaxUnlisted FaxMailing LocationMailing Address579 Flora Valley Ct, Rochester Hills, MI 48307-4784Phone(248) 765-6913FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer