Healthcare Provider Details

I. General information

NPI: 1851821946
Provider Name (Legal Business Name): MEDICAL CHOICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 BROOKSIDE AVE
WORCESTER MA
01602-1658
US

IV. Provider business mailing address

16 BROOKSIDE AVE
WORCESTER MA
01602-1658
US

V. Phone/Fax

Practice location:
  • Phone: 774-279-6899
  • Fax:
Mailing address:
  • Phone: 774-279-6899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. AUGUSTUS B KORMAH
Title or Position: CEO
Credential: AUTHORIED
Phone: 774-279-6899