MEDICARE: FIRST CHOICE HOSPICE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1003370677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HOSPICE, INC

Provider Business Mailing Address
First Line	:	3920 E PATRICK LN # 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3927
Country	:	US
Telephone Number	:	702-576-0495
Fax Number	:	705-576-0496

Provider Business Practice Location Address
First Line	:	3920 E PATRICK LN # 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3927
Country	:	US
Telephone Number	:	702-576-0495
Fax Number	:	705-576-0496

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL THOMAS CLEGG
Credential	:
Telephone Number	:	702-576-0495

Provider Enumeration Date	:	01/28/2019
Last Update Date	:	03/29/2023

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