Provider Demographics
NPI:1265181267
Name:CHOICE SPECIALTY LLC
Entity type:Organization
Organization Name:CHOICE SPECIALTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-324-2135
Mailing Address - Street 1:1025 KILLIAN HILL RD SW STE B
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-7601
Mailing Address - Country:US
Mailing Address - Phone:404-324-2135
Mailing Address - Fax:
Practice Address - Street 1:1025 KILLIAN HILL RD SW STE B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-7601
Practice Address - Country:US
Practice Address - Phone:404-324-2135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy