Provider Demographics
NPI:1588757926
Name:FIRST CHOICE RX INFUSION LLC
Entity type:Organization
Organization Name:FIRST CHOICE RX INFUSION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MMCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-357-0203
Mailing Address - Street 1:111 NW 183RD ST
Mailing Address - Street 2:STE 110
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4537
Mailing Address - Country:US
Mailing Address - Phone:305-653-4270
Mailing Address - Fax:305-653-4208
Practice Address - Street 1:111 NW 183RD ST
Practice Address - Street 2:STE 110
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4537
Practice Address - Country:US
Practice Address - Phone:305-653-4270
Practice Address - Fax:305-653-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH217543336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1021891OtherNCPDP PROVIDER IDENTIFICATION NUMBER