Provider Demographics
NPI:1093120883
Name:FIRST CHOICE CARE, LLC
Entity Type:Organization
Organization Name:FIRST CHOICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:314-699-0919
Mailing Address - Street 1:106 FOUR SEASONS SHOPPING CTR STE C
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3157
Mailing Address - Country:US
Mailing Address - Phone:314-699-0919
Mailing Address - Fax:
Practice Address - Street 1:106 FOUR SEASONS SHOPPING CTR STE C
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3157
Practice Address - Country:US
Practice Address - Phone:314-699-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012009252261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care