MEDICARE: FIRST CHOICE MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04832010	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1992721518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	3325 BARTLETT BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-6428
Country	:	US
Telephone Number	:	407-206-0040
Fax Number	:	407-206-0010

Provider Business Practice Location Address
First Line	:	8214 N UNIVERSITY ST
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-1845
Country	:	US
Telephone Number	:	309-681-8166
Fax Number	:	309-681-8190

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEPHEN GRIGGS
Credential	:
Telephone Number	:	407-206-0040

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	09/23/2021

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