Provider Demographics
NPI:1902829153
Name:FIRST CHOICE COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:FIRST CHOICE COMMUNITY HEALTH CENTERS
Other - Org Name:ANDERSON CREEK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:L
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:910-817-4064
Practice Address - Street 1:6750 OVERHILLS RD
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-8872
Practice Address - Country:US
Practice Address - Phone:910-436-2900
Practice Address - Fax:910-436-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344510AMedicaid
2804091OtherMEDICARE PART B
NC344510AMedicaid