Provider Demographics
NPI:1730371790
Name:PHYSICIAN'S CHOICE MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:PHYSICIAN'S CHOICE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:EBERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-549-9201
Mailing Address - Street 1:7 DUNWOODY PARK STE 108
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6711
Mailing Address - Country:US
Mailing Address - Phone:404-551-6502
Mailing Address - Fax:706-467-2909
Practice Address - Street 1:7 DUNWOODY PARK STE 108
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6711
Practice Address - Country:US
Practice Address - Phone:404-551-6502
Practice Address - Fax:706-467-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GABT0089640332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5997550001Medicare NSC