Choice Source Therapeutic South LLC

NPI #1720069628 in Daphne, Alabama

Provider Information

NPI Number: 1720069628
Entity Type: Organization
Organization Name: Choice Source Therapeutic South LLC
Primary Specialty: Pharmacy - Specialty Pharmacy
Enumeration Date: Nov 8, 2005
Last Updated: Aug 20, 2007

Practice Location

Address: 1048 STANTON RD
Address 2: SUITE A
City: Daphne
State: Alabama
ZIP Code: 36526-4294
Phone: (251) 621-5300

Authorized Official

Name: MR. DAVID WILLIAM BORDER
Title: AUTHORIZED SIGNER
Phone: (800) 225-5967

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X
Pharmacy - Specialty Pharmacy — Specialty Pharmacy	3336S0011X	Primary

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