Provider Demographics
NPI:1235667379
Name:1ST CHOICE PRESCRIPTIONS LLC
Entity Type:Organization
Organization Name:1ST CHOICE PRESCRIPTIONS LLC
Other - Org Name:1ST CHOICE PRESCRIPTIONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-607-4978
Mailing Address - Street 1:8111 LBJ FWY STE 540
Mailing Address - Street 2:#540
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1444
Mailing Address - Country:US
Mailing Address - Phone:972-607-4978
Mailing Address - Fax:972-692-6793
Practice Address - Street 1:8111 LBJ FWY
Practice Address - Street 2:#540
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1313
Practice Address - Country:US
Practice Address - Phone:972-607-4978
Practice Address - Fax:972-692-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX290143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2169328OtherPK