MEDICARE: PHYSICIAN'S CHOICE MEDICAL, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932324621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN'S CHOICE MEDICAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 550309
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-0309
Country	:	US
Telephone Number	:	205-566-1674
Fax Number	:

Provider Business Practice Location Address
First Line	:	565 E 70TH AVE UNIT 2W
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80229-6713
Country	:	US
Telephone Number	:	303-429-7300
Fax Number	:	303-487-5365

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LONNIE BLAKE DORCEY
Credential	:
Telephone Number	:	205-566-1674

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	06/30/2023

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