1457893117 NPI number — 1ST CHOICE IN-HOMECARE, INC.

Table of content: (NPI 1457893117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457893117 NPI number — 1ST CHOICE IN-HOMECARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
1ST CHOICE IN-HOMECARE, 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:
FIRST CHOICE
Provider Other Organization Name Type Code:
3
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:
1457893117
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3325 BARTLETT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32811-6428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-206-0040
Provider Business Mailing Address Fax Number:
407-206-0010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
321 ED WRIGHT LN STE B&C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23606-4482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-496-2030
Provider Business Practice Location Address Fax Number:
757-496-0604
Provider Enumeration Date:
11/12/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GRIGGS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
407-206-0040

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1457893117 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".