Provider Demographics
NPI:1346904471
Name:FIRST CHOICE MEDRIDE EXPRESS LLC
Entity Type:Organization
Organization Name:FIRST CHOICE MEDRIDE EXPRESS LLC
Other - Org Name:FIRST CHOICE MEDRIDE EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:W
Authorized Official - Last Name:FIRESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-780-7773
Mailing Address - Street 1:340 N MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-3360
Mailing Address - Country:US
Mailing Address - Phone:276-780-7773
Mailing Address - Fax:
Practice Address - Street 1:340 N MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-3360
Practice Address - Country:US
Practice Address - Phone:276-780-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)