MEDICARE: FIRST CHOICE HEALTHCARE, 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1730596693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	12400 W OVERLAND RD
Second Line	:	SUITE 100
City	:	BOISE
State	:	ID
Zip	:	83709-0021
Country	:	US
Telephone Number	:	208-322-7061
Fax Number	:	208-321-7052

Provider Business Practice Location Address
First Line	:	12400 W OVERLAND RD
Second Line	:	SUITE 100
City	:	BOISE
State	:	ID
Zip	:	83709-0021
Country	:	US
Telephone Number	:	208-322-7061
Fax Number	:	208-321-7052

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MS. KARA L. CRAIG
Credential	:	M.A.
Telephone Number	:	208-322-7061

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	01/03/2024

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