Provider Demographics
NPI:1952349748
Name:CHOICE MEDICAL SUPPLY COMPANY
Entity Type:Organization
Organization Name:CHOICE MEDICAL SUPPLY COMPANY
Other - Org Name:CHOICE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FOR PHARMACY SERVICE
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS PD
Authorized Official - Phone:410-552-9595
Mailing Address - Street 1:1311 LONDONTOWN BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6454
Mailing Address - Country:US
Mailing Address - Phone:410-552-9595
Mailing Address - Fax:410-552-9599
Practice Address - Street 1:1311 LONDONTOWN BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6454
Practice Address - Country:US
Practice Address - Phone:410-552-9595
Practice Address - Fax:410-552-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4083849Medicaid
MD4083849Medicaid