MEDICARE: PHYSICIANS CHOICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1275538308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS CHOICE, LLC

Provider Business Mailing Address
First Line	:	4003 OUT LOOK DR
Second Line	:	STE 1
City	:	HURRICANE
State	:	WV
Zip	:	25526-9468
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4003 OUT LOOK DR
Second Line	:	STE 1
City	:	HURRICANE
State	:	WV
Zip	:	25526-9468
Country	:	US
Telephone Number	:	304-757-4880
Fax Number	:

Authorized Official
Title or Position	:	REIMBURSEMENT MANAGER
Name	:	CYNTHIA SPENCER
Credential	:
Telephone Number	:	304-757-4880

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/22/2020

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Directions to “PHYSICIANS CHOICE, LLC ” Practice Location

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