Healthcare Provider Details

I. General information

NPI: 1033108964
Provider Name (Legal Business Name): FIRST CHOICE HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 CARTHAGE ST
SANFORD NC
27330-4105
US

IV. Provider business mailing address

506 CARTHAGE ST
SANFORD NC
27330-4105
US

V. Phone/Fax

Practice location:
  • Phone: 919-775-3306
  • Fax: 919-775-6056
Mailing address:
  • Phone: 919-775-3306
  • Fax: 919-775-6056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberHC2070
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberHC1717
License Number StateNC

VIII. Authorized Official

Name: MRS. SANDRA BRIDGES
Title or Position: PRESIDENT
Credential: R.N.
Phone: 919-775-3306