Provider Demographics
NPI:1710124664
Name:FIRST CHOICE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:FIRST CHOICE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:770-498-2170
Mailing Address - Street 1:2165 W PARK CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3550
Mailing Address - Country:US
Mailing Address - Phone:770-498-2170
Mailing Address - Fax:770-783-8036
Practice Address - Street 1:2165 W PARK CT
Practice Address - Street 2:SUITE A
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3550
Practice Address - Country:US
Practice Address - Phone:770-498-2170
Practice Address - Fax:770-783-8036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5133770001Medicare NSC