Provider Demographics
NPI:1164527578
Name:CLEAR CHOICE HOME MEDICAL EQUIPMENT & SUPPLIES
Entity Type:Organization
Organization Name:CLEAR CHOICE HOME MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-350-5638
Mailing Address - Street 1:2828 HWY 31 SOUTH
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603
Mailing Address - Country:US
Mailing Address - Phone:256-350-5638
Mailing Address - Fax:256-350-5962
Practice Address - Street 1:2828 HWY 31 SOUTH
Practice Address - Street 2:SUITE 130
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603
Practice Address - Country:US
Practice Address - Phone:256-350-5638
Practice Address - Fax:256-350-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL651332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51529482OtherBLUE CROSS
AL009932926Medicaid
AL009932926Medicaid