FAST PACE MEDICAL CLINIC PLLC; NPI #1598420929

Contact Information

FAST PACE MEDICAL CLINIC PLLC

1359 W MARKET ST
BOLIVAR, TN 38008-1702

Phone: 731-361-1003
Fax: 731-361-1004
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for FAST PACE MEDICAL CLINIC PLLC

NPI Number 1598420929

LBN Legal business name FAST PACE MEDICAL CLINIC PLLC

Authorized official ROBERT BENSON - (COO)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/01/2021

Last updated 11/01/2021 - About 5 years ago

Identifiers

Medicaid

1515574

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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