Provider Demographics
NPI:1467486639
Name:CHOICE MEDICAL INC
Entity Type:Organization
Organization Name:CHOICE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENETHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-647-1965
Mailing Address - Street 1:189 SMOKE RISE TRL
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-4295
Mailing Address - Country:US
Mailing Address - Phone:205-647-1965
Mailing Address - Fax:205-647-1966
Practice Address - Street 1:189 SMOKE RISE TRL
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-4295
Practice Address - Country:US
Practice Address - Phone:205-647-1965
Practice Address - Fax:205-647-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL619332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51520958OtherBLUE CROSS DME PROVIDER
AL51520958OtherBLUE CROSS DME PROVIDER
AL=========OtherVIVA DME PROV #
AL51520958OtherBLUE CROSS DME PROVIDER