Individual ProviderJoseph McculloughInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address56 Franklin St, Waterbury, CT 06706(203) 753-2754PECOS EnrollmentBased on the most recent information from CMS, provider Joseph Mccullough 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 ID1861803025Provider TypeIndividualFull NameMccullough, JosephTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date5/9/2014Last Updated7/3/2018Contact InformationPractice LocationPractice Address56 Franklin St, Waterbury, CT 06706Phone(203) 753-2754FaxUnlisted FaxMailing LocationMailing Address56 Franklin St, Waterbury, CT 06706-1253PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense56560ConnecticutCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer