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General NPI Number Information
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NPI Number | 1194491019
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Entity Type | Organization
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Legal Business Name | DRS CHOICE FIRST
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1912 HAMILTON ST STE 108
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2077
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Country | US
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Telephone | 904-800-2375
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Fax | 904-800-2375
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Provider Business Mailing Address
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Address Line | 1912 HAMILTON ST STE 108
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2077
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Country | US
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Telephone | 904-800-2375
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Fax | 904-800-2642
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Authorized Official
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Title or Position | MANAGER
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Name | MELISSA FREEMAN
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Credential |
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Telephone | 904-800-2375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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