MEDICARE: 1ST CHOICE PRESCRIPTIONS LLC

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	3336C0003X	Community/Retail Pharmacy	29014	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2145715	OTHER		PK

General Provider Information

NPI Number	:	1467863316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST CHOICE PRESCRIPTIONS LLC

Provider Business Mailing Address
First Line	:	2056 ANTOINE DR
Second Line	:	#120
City	:	HOUSTON
State	:	TX
Zip	:	77055-1833
Country	:	US
Telephone Number	:	832-582-8109
Fax Number	:	832-582-8129

Provider Business Practice Location Address
First Line	:	2056 ANTOINE DR
Second Line	:	#120
City	:	HOUSTON
State	:	TX
Zip	:	77055-1833
Country	:	US
Telephone Number	:	832-582-8109
Fax Number	:	832-582-8129

Authorized Official
Title or Position	:	OWNER
Name	:	WAYMON BARRETT
Credential	:
Telephone Number	:	713-504-5199

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	05/14/2014

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Directions to “1ST CHOICE PRESCRIPTIONS LLC ” Practice Location

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