MEDICARE: FIRST CHOICE HOME MEDICAL, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639228711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HOME MEDICAL, INC

Provider Business Mailing Address
First Line	:	5416 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2072
Country	:	US
Telephone Number	:	405-702-6656
Fax Number	:	405-702-6659

Provider Business Practice Location Address
First Line	:	5416 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2072
Country	:	US
Telephone Number	:	405-702-6656
Fax Number	:	405-702-6659

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CRUZ MALDONADO
Credential	:
Telephone Number	:	405-702-6656

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	02/29/2012

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Directions to “FIRST CHOICE HOME MEDICAL, INC ” Practice Location

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