Healthcare Provider Details

I. General information

NPI: 1366909798
Provider Name (Legal Business Name): ARIZONA'S FIRST CHOICE MEDICAL SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 N 19TH AVE STE 102
PHOENIX AZ
85015-3211
US

IV. Provider business mailing address

5060 N 19TH AVE STE 102
PHOENIX AZ
85015-3211
US

V. Phone/Fax

Practice location:
  • Phone: 602-296-5540
  • Fax: 602-296-5442
Mailing address:
  • Phone: 602-296-5540
  • Fax: 602-296-5442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA ANNA GARCIA
Title or Position: OWNER
Credential:
Phone: 602-296-5540