Provider Demographics
NPI:1912425802
Name:CHOICE MEDICAL, LLC
Entity type:Organization
Organization Name:CHOICE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:864-655-4757
Mailing Address - Street 1:104 MIDDLETON WAY STE D
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1323
Mailing Address - Country:US
Mailing Address - Phone:864-655-4757
Mailing Address - Fax:
Practice Address - Street 1:104 MIDDLETON WAY STE D
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1323
Practice Address - Country:US
Practice Address - Phone:864-655-4757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies