Healthcare Provider Details

I. General information

NPI: 1366498735
Provider Name (Legal Business Name): 1ST CHOICE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date: 06/09/2006
Reactivation Date: 06/09/2006

III. Provider practice location address

1016 MCQUAY AVE
POCAHONTAS AR
72422
US

IV. Provider business mailing address

PO BOX 83
CORNING AR
72422-0083
US

V. Phone/Fax

Practice location:
  • Phone: 870-892-9949
  • Fax: 870-892-0208
Mailing address:
  • Phone: 870-857-3334
  • Fax: 870-857-9934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: SYDNEY STEVENS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 870-857-3334