Provider Demographics
NPI:1447411632
Name:FIRST CHOICE COMMUNITY HEALTHCARE, INC.
Entity type:Organization
Organization Name:FIRST CHOICE COMMUNITY HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-241-5182
Mailing Address - Street 1:PO BOX 912678
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-2678
Mailing Address - Country:US
Mailing Address - Phone:505-241-5182
Mailing Address - Fax:
Practice Address - Street 1:120 S 9TH ST
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3102
Practice Address - Country:US
Practice Address - Phone:505-861-1013
Practice Address - Fax:505-224-8717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM321852Medicare Oscar/Certification