Provider Demographics
NPI:1417968744
Name:1ST CHOICE MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:1ST CHOICE MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:575-762-9111
Mailing Address - Street 1:1729 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4021
Mailing Address - Country:US
Mailing Address - Phone:575-762-9111
Mailing Address - Fax:575-763-1230
Practice Address - Street 1:1729 W 21ST ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4021
Practice Address - Country:US
Practice Address - Phone:575-762-9111
Practice Address - Fax:575-763-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1171530001Medicare NSC