Provider Demographics
NPI:1851524870
Name:FIRST CHOICE COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:FIRST CHOICE COMMUNITY HEALTH CENTERS
Other - Org Name:MOBILE MEDICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-364-0971
Mailing Address - Street 1:40 AUTUMN FERN TRL
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-5155
Mailing Address - Country:US
Mailing Address - Phone:910-364-0971
Mailing Address - Fax:910-814-4064
Practice Address - Street 1:1000 MEDICAL CENTER ROAD
Practice Address - Street 2:HWY 421
Practice Address - City:MAMERS
Practice Address - State:NC
Practice Address - Zip Code:27552-0397
Practice Address - Country:US
Practice Address - Phone:910-893-5402
Practice Address - Fax:910-893-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)