MEDICARE: FIRST CHOICE MEDICAL TRANSPORT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1787	NC

General Provider Information

NPI Number	:	1215202734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE MEDICAL TRANSPORT, LLC

Provider Business Mailing Address
First Line	:	123 SUMMER LAKES DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-3419
Country	:	US
Telephone Number	:	800-380-7909
Fax Number	:	800-380-7909

Provider Business Practice Location Address
First Line	:	123 SUMMER LAKES DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-3419
Country	:	US
Telephone Number	:	800-380-7909
Fax Number	:	800-380-7909

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MRS. DINA SANTOS-BORCK
Credential	:	EMT
Telephone Number	:	800-380-7909

Provider Enumeration Date	:	03/16/2012
Last Update Date	:	03/27/2012

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