Individual ProviderJosephine WallaceCase Manager/Care CoordinatorOther Service ProvidersPractice Address2052 Galisteo St, Santa Fe, NM 87505-2100(505) 819-3419PECOS EnrollmentBased on the most recent information from CMS, provider Josephine Wallace 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 9:43 AM.Profile DetailsProvider ID1982409637Provider TypeIndividualFull NameWallace, JosephineGenderFemaleSole ProprietorNoEnumeration Date2/17/2025Last Updated2/17/2025Contact InformationPractice LocationPractice Address2052 Galisteo St, Santa Fe, NM 87505-2100Phone(505) 819-3419FaxUnlisted FaxMailing LocationMailing Address2052 Galisteo St, Santa Fe, NM 87505-2100PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer