=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841498466
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREFERRED CHOICE BUSINESS SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2007
-----------------------------------------------------
Last Update Date | 04/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 132 ROUTLEDGE ST
-----------------------------------------------------
City | KENANSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28349-9711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-296-6144
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 278
-----------------------------------------------------
City | BEULAVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-941-4273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MRS. CHRISTINA M ROGERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-941-4273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------