Provider Demographics
NPI:1740409150
Name:FIRST CHOICE DRUG TESTING AND OCCUPATIONAL HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:FIRST CHOICE DRUG TESTING AND OCCUPATIONAL HEALTH SERVICES INC.
Other - Org Name:FIRST CHOICE DRUG TESTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-661-9992
Mailing Address - Street 1:1423 SOUTH UNIVERSITY AVE.
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2605
Mailing Address - Country:US
Mailing Address - Phone:501-661-9992
Mailing Address - Fax:501-661-9092
Practice Address - Street 1:1423 SOUTH UNIVERSITY AVE.
Practice Address - Street 2:BUILDING 2
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2605
Practice Address - Country:US
Practice Address - Phone:501-661-9992
Practice Address - Fax:501-661-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8478251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare