Healthcare Provider Details

I. General information

NPI: 1679576367
Provider Name (Legal Business Name): 1ST CHOICE HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 E REDOUBT AVE
SOLDOTNA AK
99669-8013
US

IV. Provider business mailing address

159 E REDOUBT AVE
SOLDOTNA AK
99669-8013
US

V. Phone/Fax

Practice location:
  • Phone: 907-260-5959
  • Fax: 907-262-5498
Mailing address:
  • Phone: 907-260-5959
  • Fax: 907-260-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberN/A
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA CARNELL
Title or Position: PRESIDENT/CEO
Credential: RN BSN
Phone: 907-260-5959