Provider Demographics
NPI:1366233652
Name:INFORMED CHOICE MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:INFORMED CHOICE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PUNGELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-390-4355
Mailing Address - Street 1:101 E LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:VIVIAN
Mailing Address - State:LA
Mailing Address - Zip Code:71082-2923
Mailing Address - Country:US
Mailing Address - Phone:813-390-4355
Mailing Address - Fax:
Practice Address - Street 1:105 E LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:VIVIAN
Practice Address - State:LA
Practice Address - Zip Code:71082-2923
Practice Address - Country:US
Practice Address - Phone:903-495-2648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies