MEDICARE: FIRST CHOICE TRANSPORTATION

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	343900000X	Non-emergency Medical Transport (VAN)	K01935698	KS

General Provider Information

NPI Number	:	1700157500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE TRANSPORTATION

Provider Business Mailing Address
First Line	:	P.O.BOX 204
Second Line	:
City	:	VAUGHN
State	:	NM
Zip	:	88353
Country	:	US
Telephone Number	:	575-584-1895
Fax Number	:	575-584-1895

Provider Business Practice Location Address
First Line	:	4118 BOTANY LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-1808
Country	:	US
Telephone Number	:	575-584-1895
Fax Number	:	575-584-1895

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DONALD EDISON
Credential	:
Telephone Number	:	575-584-1895

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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Directions to “FIRST CHOICE TRANSPORTATION ” Practice Location

Language	Start Address	Practice Location

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