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General NPI Number Information
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NPI Number | 1922544303
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Entity Type | Organization
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Legal Business Name | PHYSICIAN'S CHOICE HEALTHCARE SERVICES, INC
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 10108 FREESIAN WAY
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City | WELLINGTON
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State | FL
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Zip | 33449-8030
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Country | US
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Telephone | 561-714-7858
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Fax | 561-549-1207
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Provider Business Mailing Address
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Address Line | 125 S STATE ROAD 7 104-114
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City | WELLINGTON
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State | FL
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Zip | 33414-4385
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Country | US
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Telephone | 561-714-7858
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Fax | 561-549-1207
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Authorized Official
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Title or Position | CEO
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Name | DR. JERRY CHARLES
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Credential | M.D.
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Telephone | 561-714-7858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 234679
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License Number State | FL
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