Provider Demographics
NPI:1659773778
Name:FIRST CHOICE HOME MEDICAL INC
Entity Type:Organization
Organization Name:FIRST CHOICE HOME MEDICAL INC
Other - Org Name:GEARY COMMUNITY NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRUZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-582-2100
Mailing Address - Street 1:720 N GALENA AVE
Mailing Address - Street 2:PO BOX 47
Mailing Address - City:GEARY
Mailing Address - State:OK
Mailing Address - Zip Code:73040-1501
Mailing Address - Country:US
Mailing Address - Phone:405-884-5440
Mailing Address - Fax:405-884-2749
Practice Address - Street 1:720 N GALENA AVE
Practice Address - Street 2:
Practice Address - City:GEARY
Practice Address - State:OK
Practice Address - Zip Code:73040-1501
Practice Address - Country:US
Practice Address - Phone:405-884-5440
Practice Address - Fax:405-884-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH-0602-0602313M00000X
OKNH0602-0602314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200117080AMedicaid
OK200117080AMedicaid