Provider Demographics
NPI:1376949263
Name:CHOICES, INC
Entity Type:Organization
Organization Name:CHOICES, INC
Other - Org Name:MARYLAND CHOICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:317-726-2121
Mailing Address - Street 1:4701 N KEYSTONE AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-1554
Mailing Address - Country:US
Mailing Address - Phone:317-726-2121
Mailing Address - Fax:317-726-2130
Practice Address - Street 1:300 TALBOT ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3525
Practice Address - Country:US
Practice Address - Phone:877-565-5392
Practice Address - Fax:866-397-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1447508254Medicare PIN