Healthcare Provider Details

I. General information

NPI: 1962663153
Provider Name (Legal Business Name): FIRST CHOICE COMMUNITY HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MUNICIPAL WAY
EDGEWOOD NM
87015-7086
US

IV. Provider business mailing address

2001 N. CENTRO FAMILIAR BLVD SW
ALBUQUERQUE NM
87105-4592
US

V. Phone/Fax

Practice location:
  • Phone: 505-281-3406
  • Fax: 505-224-8737
Mailing address:
  • Phone: 505-873-7462
  • Fax: 505-241-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMIAH DYE
Title or Position: CEO
Credential: DDS
Phone: 505-873-7401