Basic Information
Provider Information
NPI: 1821699026
EntityType: 2
ReplacementNPI:  
OrganizationName: FIRST CHOICE MEDICAL EQUIPMENT, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: IV AND RESPIRATORY CARE SERVICES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3325 BARTLETT BLVD
Address2:  
City: ORLANDO
State: FL
PostalCode: 328116428
CountryCode: US
TelephoneNumber: 4075152070
FaxNumber:  
Practice Location
Address1: 65 S 65TH ST STE 10
Address2:  
City: BELLEVILLE
State: IL
PostalCode: 622232946
CountryCode: US
TelephoneNumber: 6367301320
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/04/2020
LastUpdateDate: 09/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO/PRESIDENT
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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