1174421507 NPI number — FIRST CHOICE COMMUNITY HEALTHCARE, INC.

Table of content: (NPI 1174421507)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174421507 NPI number — FIRST CHOICE COMMUNITY HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST CHOICE COMMUNITY HEALTHCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174421507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 CENTRO FAMILIAR BLVD SW
Provider Second Line Business Mailing Address:
ATTN: FIRST CHOICE COMMUNITY HEALTHCARE PHARMACY
Provider Business Mailing Address City Name:
ALBUQUERQUE NM 87105
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87105-4592
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-241-5182
Provider Business Mailing Address Fax Number:
505-224-8713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2820 C BROADBENT PKWY NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-241-5182
Provider Business Practice Location Address Fax Number:
505-224-8713
Provider Enumeration Date:
10/27/2026

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALES
Authorized Official First Name:
SHAWNA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
505-873-7414

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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