MEDICARE: CHOICE HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PO6346	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2144765	OTHER		PK

General Provider Information

NPI Number	:	1134544828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOICE HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	9151 REISTERSTOWN RD
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4503
Country	:	US
Telephone Number	:	410-363-8222
Fax Number	:	410-363-2133

Provider Business Practice Location Address
First Line	:	23 CROSSROADS DR STE 110
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-5476
Country	:	US
Telephone Number	:	410-363-9900
Fax Number	:	410-363-8900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VENKAT CHALASANI
Credential	:
Telephone Number	:	443-802-7006

Provider Enumeration Date	:	03/04/2014
Last Update Date	:	02/16/2015

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Directions to “CHOICE HEALTH SERVICES INC ” Practice Location

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