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General NPI Number Information
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NPI Number | 1598279655
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Entity Type | Organization
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Legal Business Name | 1ST CHOICE DME SUPPLY LLC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 1900 THE EXCHANGE SE STE 345
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City | ATLANTA
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State | GA
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Zip | 30339-2049
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Country | US
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Telephone | 678-618-3852
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 THE EXCHANGE SE STE 345
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City | ATLANTA
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State | GA
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Zip | 30339-2049
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Country | US
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Telephone | 678-618-3852
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | CALVENA WINSTON
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Credential |
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Telephone | 404-406-6307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | OCC018144
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License Number State | GA
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