Healthcare Provider Details

I. General information

NPI: 1194491019
Provider Name (Legal Business Name): DRS CHOICE FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 HAMILTON ST STE 108
JACKSONVILLE FL
32210-2077
US

IV. Provider business mailing address

1912 HAMILTON ST STE 108
JACKSONVILLE FL
32210-2077
US

V. Phone/Fax

Practice location:
  • Phone: 904-800-2375
  • Fax: 904-800-2375
Mailing address:
  • Phone: 904-800-2375
  • Fax: 904-800-2642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FREEMAN
Title or Position: MANAGER
Credential:
Phone: 904-800-2375