Provider Demographics
NPI:1124071519
Name:FIRST CHOICE PHARMACY
Entity type:Organization
Organization Name:FIRST CHOICE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-754-7852
Mailing Address - Street 1:411 GREENVILLE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-9142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:616-754-6072
Practice Address - Street 1:411 GREENVILLE PLAZA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-9142
Practice Address - Country:US
Practice Address - Phone:616-754-7852
Practice Address - Fax:616-754-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010035521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2329527Medicaid
MI2329527Medicaid