Provider Demographics
NPI:1639228711
Name:FIRST CHOICE HOME MEDICAL, INC
Entity Type:Organization
Organization Name:FIRST CHOICE HOME MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-702-6656
Mailing Address - Street 1:5416 N PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2072
Mailing Address - Country:US
Mailing Address - Phone:405-702-6656
Mailing Address - Fax:405-702-6659
Practice Address - Street 1:5416 N PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2072
Practice Address - Country:US
Practice Address - Phone:405-702-6656
Practice Address - Fax:405-702-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200108060AMedicaid
OK200108060AMedicaid