Provider Demographics
NPI:1871817122
Name:JOHN BOWMAN DBA/CHOICE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:JOHN BOWMAN DBA/CHOICE MEDICAL SUPPLY
Other - Org Name:CHOICE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-742-8539
Mailing Address - Street 1:6073 45TH AVE N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-5106
Mailing Address - Country:US
Mailing Address - Phone:727-742-8539
Mailing Address - Fax:727-471-8223
Practice Address - Street 1:6073 45TH AVE N
Practice Address - Street 2:
Practice Address - City:KENNETH CITY
Practice Address - State:FL
Practice Address - Zip Code:33709-5106
Practice Address - Country:US
Practice Address - Phone:727-742-8539
Practice Address - Fax:727-471-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BN1400X
FL628012466451332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies