Provider Demographics
NPI:1184617094
Name:FIRST CHOICE MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:FIRST CHOICE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ARFARAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-759-2603
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-0066
Mailing Address - Country:US
Mailing Address - Phone:330-759-2603
Mailing Address - Fax:330-759-2569
Practice Address - Street 1:4451 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1977
Practice Address - Country:US
Practice Address - Phone:330-847-0919
Practice Address - Fax:330-847-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000354979OtherANTHEM
WV1065329OtherWV WORK COMP
PA1679773OtherHIGHMARK
OH2532272Medicaid
6058960000OtherOWCP
PA1012276200001Medicaid
PA1012276200001Medicaid
OH000000354979OtherANTHEM
5190450001Medicare ID - Type Unspecified