Provider Demographics
NPI:1609855196
Name:FIRST CHOICE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:FIRST CHOICE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-928-3760
Mailing Address - Street 1:4200 N CLOVERLEAF DR STE O
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6436
Mailing Address - Country:US
Mailing Address - Phone:636-928-3760
Mailing Address - Fax:
Practice Address - Street 1:4200 N. CLOVERLEAF DR
Practice Address - Street 2:STE O
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6436
Practice Address - Country:US
Practice Address - Phone:636-928-3760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO582-8251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO588890004Medicaid
MO19820OtherHCUSA
MO26-7535Medicare PIN