MEDICARE: MY CHOICE HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760217764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY CHOICE HOME CARE LLC

Provider Business Mailing Address
First Line	:	348 S 5TH ST STE 209
Second Line	:
City	:	HIGHLANDS
State	:	NC
Zip	:	28741-7002
Country	:	US
Telephone Number	:	888-505-2965
Fax Number	:	828-333-5702

Provider Business Practice Location Address
First Line	:	348 S 5TH ST STE 209
Second Line	:
City	:	HIGHLANDS
State	:	NC
Zip	:	28741-7002
Country	:	US
Telephone Number	:	888-505-2965
Fax Number	:	828-333-5702

Authorized Official
Title or Position	:	CORPORATE OFFICER - SECRETARY
Name	:	PAUL WHEELER
Credential	:
Telephone Number	:	828-200-4312

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	09/09/2024

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