Provider Demographics
NPI:1093888018
Name:DAVID HUDSON WARREN
Entity Type:Organization
Organization Name:DAVID HUDSON WARREN
Other - Org Name:FIRST CHOICE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HUDSON
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-289-3334
Mailing Address - Street 1:1200 OVERSTREAM LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6755
Mailing Address - Country:US
Mailing Address - Phone:704-289-3334
Mailing Address - Fax:704-844-8156
Practice Address - Street 1:251 N TRADE ST
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1713
Practice Address - Country:US
Practice Address - Phone:704-289-3334
Practice Address - Fax:704-844-8156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01049332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5836360001Medicare NSC