MEDICARE: PREMIER CHOICE DME

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	:	1942443734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER CHOICE DME

Provider Business Mailing Address
First Line	:	2733 N SAN FERNANDO RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-1318
Country	:	US
Telephone Number	:	323-224-8004
Fax Number	:	323-224-8008

Provider Business Practice Location Address
First Line	:	2733 N SAN FERNANDO RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-1318
Country	:	US
Telephone Number	:	323-224-8004
Fax Number	:	323-224-8008

Authorized Official
Title or Position	:	PRINCIPLE
Name	:	MICHELE T SCHRADER
Credential	:
Telephone Number	:	323-224-8004

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	04/09/2009

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Directions to “PREMIER CHOICE DME ” Practice Location

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