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General NPI Number Information
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NPI Number | 1508853169
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE HOME MEDICAL, INC.
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 720 N GALENA
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City | GEARY
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State | OK
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Zip | 73040-2801
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Country | US
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Telephone | 405-884-5440
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Fax | 405-884-5439
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Provider Business Mailing Address
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Address Line | P.O. BOX 47 720 N. GALENA ST.
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City | GEARY
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State | OK
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Zip | 73040-2801
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Country | US
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Telephone | 405-884-5440
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Fax | 405-884-2749
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Authorized Official
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Title or Position | C.E.O.
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Name | MR. CRUZ A MALDONADO
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Credential | PRESIDENT OF COMPANY
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Telephone | 405-802-4483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0602-0602
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH0602-0602
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License Number State | OK
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