Provider Demographics
NPI:1538137195
Name:CHOICE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:CHOICE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FUGITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-250-5003
Mailing Address - Street 1:500 N 56TH ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2506
Mailing Address - Country:US
Mailing Address - Phone:888-250-5003
Mailing Address - Fax:888-250-5001
Practice Address - Street 1:500 N 56TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2506
Practice Address - Country:US
Practice Address - Phone:888-250-5003
Practice Address - Fax:888-250-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVH13-00157-4-097424332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1150300001Medicare NSC