Individual ProviderShontilla CookCase Manager/Care CoordinatorOther Service ProvidersPractice Address634 W Main St, Blytheville, AR 72315-3336(870) 780-6986PECOS EnrollmentBased on the most recent information from CMS, provider Shontilla Cook 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 3 days ago.Profile DetailsProvider ID1699100677Provider TypeIndividualFull NameCook, ShontillaCredentialMHPPGenderFemaleSole ProprietorNoEnumeration Date9/9/2013Last Updated9/9/2013Contact InformationPractice LocationPractice Address634 W Main St, Blytheville, AR 72315-3336Phone(870) 780-6986Fax(870) 780-6987Mailing LocationMailing Address634 W Main St, Blytheville, AR 72315-3336Phone(870) 780-6986Fax(870) 780-6987Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer