Provider Demographics
NPI:1265143069
Name:FIRST CHOICE DIAGNOSTIC SERVICES LLC
Entity type:Organization
Organization Name:FIRST CHOICE DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-270-0030
Mailing Address - Street 1:1569 GLENDALE MILL RD
Mailing Address - Street 2:
Mailing Address - City:FREEMAN
Mailing Address - State:VA
Mailing Address - Zip Code:23856-2447
Mailing Address - Country:US
Mailing Address - Phone:434-270-0030
Mailing Address - Fax:434-270-0030
Practice Address - Street 1:1569 GLENDALE MILL RD
Practice Address - Street 2:
Practice Address - City:FREEMAN
Practice Address - State:VA
Practice Address - Zip Code:23856-2447
Practice Address - Country:US
Practice Address - Phone:434-270-0030
Practice Address - Fax:434-270-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service