MEDICARE: FIRST CHOICE FAMILY HEALTHCARE

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	111N00000X	Chiropractor	1226	NC
2	111N00000X	Chiropractor	2806	NC
3	207Q00000X	Family Medicine Physician	26547	NC
4	207Q00000X	Family Medicine Physician	24304	NC

General Provider Information

NPI Number	:	1902869043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE FAMILY HEALTHCARE

Provider Business Mailing Address
First Line	:	4109 WAKE FOREST RD
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27609-2510
Country	:	US
Telephone Number	:	919-954-0050
Fax Number	:	919-954-1306

Provider Business Practice Location Address
First Line	:	4109 WAKE FOREST RD
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27609-2510
Country	:	US
Telephone Number	:	919-954-0050
Fax Number	:	919-954-1306

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. WENDI DAVIS
Credential	:
Telephone Number	:	919-954-0050

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	01/12/2010

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Directions to “FIRST CHOICE FAMILY HEALTHCARE ” Practice Location

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