Individual ProviderMichael A RussellCase Manager/Care CoordinatorOther Service ProvidersPractice Address3300 Pennsylvania Ave SE, Washington, DC 20020-2408(202) 491-9672PECOS EnrollmentBased on the most recent information from CMS, provider Michael A Russell 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 ID1336849694Provider TypeIndividualFull NameRussell, Michael AGenderMaleSole ProprietorYesEnumeration Date3/6/2023Last Updated6/28/2023Contact InformationPractice LocationPractice Address3300 Pennsylvania Ave SE, Washington, DC 20020-2408Phone(202) 491-9672FaxUnlisted FaxMailing LocationMailing Address3300 Pennsylvania Ave SE, Washington, DC 20020-2408Phone(202) 491-9672FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted Issuer