Individual ProviderSuneeth ChoudaryStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address128 E Apple St Fl 2, Dayton, OH 45409-2902(937) 208-2004PECOS EnrollmentBased on the most recent information from CMS, provider Suneeth Choudary is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1184366726Provider TypeIndividualFull NameChoudary, SuneethGenderMaleSole ProprietorNoEnumeration Date4/13/2022Last Updated4/13/2022Contact InformationPractice LocationPractice Address128 E Apple St Fl 2, Dayton, OH 45409-2902Phone(937) 208-2004FaxUnlisted FaxMailing LocationMailing Address128 E Apple St Fl 2, Dayton, OH 45409-2902PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID779180932322DescriptionOtherIssuerCIGNA