Healthcare Provider Details

I. General information

NPI: 1093281032
Provider Name (Legal Business Name): 1ST CHOICE TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 ALAMO ST
LAKE CHARLES LA
70601-8584
US

IV. Provider business mailing address

330 ALAMO ST
LAKE CHARLES LA
70601-8584
US

V. Phone/Fax

Practice location:
  • Phone: 347-325-3927
  • Fax:
Mailing address:
  • Phone: 347-325-3927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: AMAL IDRISSI
Title or Position: OWNER
Credential: DO
Phone: 347-325-3927