Provider Demographics
NPI:1083718332
Name:FIRSTCHOICE HEALTHCARE, PC
Entity Type:Organization
Organization Name:FIRSTCHOICE HEALTHCARE, PC
Other - Org Name:THE PAIN CENTER AT FIRSTCHOICE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-678-9777
Mailing Address - Street 1:1920 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6123
Mailing Address - Country:US
Mailing Address - Phone:843-678-9777
Mailing Address - Fax:843-665-2814
Practice Address - Street 1:4600 OLEANDER DR
Practice Address - Street 2:SUITE B
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5897
Practice Address - Country:US
Practice Address - Phone:843-497-5323
Practice Address - Fax:843-497-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6204620004Medicare NSC