Provider Demographics
NPI:1154849859
Name:FIRST CHOICE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:FIRST CHOICE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-467-4841
Mailing Address - Street 1:256 WITHERSPOON WAY STE M
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2766
Mailing Address - Country:US
Mailing Address - Phone:888-341-7295
Mailing Address - Fax:
Practice Address - Street 1:256 WITHERSPOON WAY
Practice Address - Street 2:STE. M
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:888-341-7295
Practice Address - Fax:888-920-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies