Provider Demographics
NPI:1982849949
Name:HOME CHOICE MEDICAL SUPPLY SERVICES
Entity Type:Organization
Organization Name:HOME CHOICE MEDICAL SUPPLY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:AMOAKO
Authorized Official - Last Name:ADDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-395-8604
Mailing Address - Street 1:6475 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 504B
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3269
Mailing Address - Country:US
Mailing Address - Phone:301-560-0552
Mailing Address - Fax:301-481-7183
Practice Address - Street 1:6475 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 504B
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3269
Practice Address - Country:US
Practice Address - Phone:301-560-0552
Practice Address - Fax:301-481-7183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2698332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies