Provider Demographics
NPI:1912001264
Name:FIRSTCHOICE HEALTHCARE PC
Entity Type:Organization
Organization Name:FIRSTCHOICE HEALTHCARE PC
Other - Org Name:THE PAIN CENTER AT FIRSTCHOICE HEALTHCARE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:5 OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-546-4488
Mailing Address - Street 1:115 BRUSHY CREEK
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-1120
Mailing Address - Country:US
Mailing Address - Phone:864-546-4488
Mailing Address - Fax:864-529-3981
Practice Address - Street 1:115 BRUSHY CREEK RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1120
Practice Address - Country:US
Practice Address - Phone:864-855-1633
Practice Address - Fax:864-855-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 207LP2900X, 207Q00000X
SC261QM1300X
SC1574332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC070871Medicaid
SCCH5514OtherOTHER
SCGP2339Medicaid
SCCH2443Medicaid
SC6204620001Medicare NSC
SC6672Medicare PIN