Healthcare Provider Details

I. General information

NPI: 1659446912
Provider Name (Legal Business Name): FIRST CHOICE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 3RD ST
GAYLORD MN
55334-2297
US

IV. Provider business mailing address

PO BOX 770
GAYLORD MN
55334-0770
US

V. Phone/Fax

Practice location:
  • Phone: 507-237-2933
  • Fax: 507-237-2935
Mailing address:
  • Phone: 507-237-2933
  • Fax: 507-237-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number262566
License Number StateMN

VIII. Authorized Official

Name: JILL REINHARDT
Title or Position: OWNER AND PHARM
Credential: RPH
Phone: 507-237-2933