Healthcare Provider Details

I. General information

NPI: 1659816007
Provider Name (Legal Business Name): CHOICE MEDS USA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 W HIGHWAY 50
CLERMONT FL
34711-3027
US

IV. Provider business mailing address

5703 RED BUG LAKE RD # 256
WINTER SPRINGS FL
32708-4969
US

V. Phone/Fax

Practice location:
  • Phone: 352-353-6909
  • Fax: 352-353-6911
Mailing address:
  • Phone: 407-617-6059
  • Fax: 407-900-2656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH25972
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SANDEEP MATHOW
Title or Position: FOUNDER & CEO
Credential:
Phone: 407-617-6059