Healthcare Provider Details

I. General information

NPI: 1508853169
Provider Name (Legal Business Name): FIRST CHOICE HOME MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N GALENA
GEARY OK
73040-2801
US

IV. Provider business mailing address

P.O. BOX 47 720 N. GALENA ST.
GEARY OK
73040-2801
US

V. Phone/Fax

Practice location:
  • Phone: 405-884-5440
  • Fax: 405-884-5439
Mailing address:
  • Phone: 405-884-5440
  • Fax: 405-884-2749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH0602-0602
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0602-0602
License Number StateOK

VIII. Authorized Official

Name: MR. CRUZ A MALDONADO
Title or Position: C.E.O.
Credential: PRESIDENT OF COMPANY
Phone: 405-802-4483