Healthcare Provider Details

I. General information

NPI: 1558195479
Provider Name (Legal Business Name): FIRST CHOICE TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6903 MACAWAY CRK
SAN ANTONIO TX
78244-1374
US

IV. Provider business mailing address

6903 MACAWAY CRK
SAN ANTONIO TX
78244-1374
US

V. Phone/Fax

Practice location:
  • Phone: 207-409-0402
  • Fax:
Mailing address:
  • Phone: 207-409-0402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: HERITIER RUNEZERWA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 207-409-0402