Provider Demographics
NPI:1255087904
Name:CHOICE MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:CHOICE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALADRIGA MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-362-3218
Mailing Address - Street 1:2180 W FIRST ST STE 500
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3217
Mailing Address - Country:US
Mailing Address - Phone:239-362-3218
Mailing Address - Fax:239-362-3470
Practice Address - Street 1:2180 W FIRST ST STE 500
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3217
Practice Address - Country:US
Practice Address - Phone:239-362-3218
Practice Address - Fax:239-362-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies