Provider Demographics
NPI:1336205228
Name:PHYSICIANS CHOICE HEALTH SERVICES, INC..
Entity type:Organization
Organization Name:PHYSICIANS CHOICE HEALTH SERVICES, INC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:WIGGINS
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:229-903-1122
Mailing Address - Street 1:323 PINE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2587
Mailing Address - Country:US
Mailing Address - Phone:229-903-1122
Mailing Address - Fax:229-903-1550
Practice Address - Street 1:323 PINE AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2587
Practice Address - Country:US
Practice Address - Phone:229-903-1122
Practice Address - Fax:229-903-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000548523CMedicaid
GA000640868AMedicaid
GA000548523BMedicaid