Provider Demographics
NPI:1033429501
Name:FIRST CHOICE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:FIRST CHOICE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-352-7878
Mailing Address - Street 1:127 INTERSTATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218
Mailing Address - Country:US
Mailing Address - Phone:601-352-7878
Mailing Address - Fax:601-352-7013
Practice Address - Street 1:7356 GARNERS FERRY ROAD
Practice Address - Street 2:SUITE 219
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063
Practice Address - Country:US
Practice Address - Phone:888-274-4180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment