Provider Demographics
NPI:1316242795
Name:FIRST CHOICE MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:FIRST CHOICE MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-352-7878
Mailing Address - Street 1:127 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-9485
Mailing Address - Country:US
Mailing Address - Phone:601-352-7878
Mailing Address - Fax:601-352-7013
Practice Address - Street 1:3650 W MILLER RD
Practice Address - Street 2:SUITE 430
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-6016
Practice Address - Country:US
Practice Address - Phone:469-619-5800
Practice Address - Fax:214-340-6269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0088527332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies