Healthcare Provider Details

I. General information

NPI: 1881617850
Provider Name (Legal Business Name): FIRST CHOICE COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER ROAD
MAMERS NC
27552-0397
US

IV. Provider business mailing address

40 AUTUMN FERN TRL
LILLINGTON NC
27546-5155
US

V. Phone/Fax

Practice location:
  • Phone: 910-893-3063
  • Fax: 910-897-2567
Mailing address:
  • Phone: 910-364-0971
  • Fax: 910-814-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHEILA L SIMMONS
Title or Position: CEO
Credential:
Phone: 910-364-0971