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General NPI Number Information
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NPI Number | 1568429314
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Entity Type | Organization
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Legal Business Name | 1ST. CHOICE MEDICAL
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 1815 BLOOM RD
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City | DANVILLE
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State | PA
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Zip | 17821-8510
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Country | US
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Telephone | 570-271-2525
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Fax | 570-271-1711
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Provider Business Mailing Address
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Address Line | 1815 BLOOM RD
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City | DANVILLE
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State | PA
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Zip | 17821-8510
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Country | US
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Telephone | 570-271-2525
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Fax | 570-271-1711
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROGER L HEINTZELMAN
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Credential | CF-O
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Telephone | 570-271-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 6000004964
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License Number State | PA
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